Avoiding stay in the intensive care unit after liver transplantation: A score to assign location of care

I. G. Bulatao, M. G. Heckman, B. Rawal, S. Aniskevich, T. S. Shine, A. P. Keaveny, D. K. Perry, J. Canabal, D. L. Willingham, C. B. Taner

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Select liver transplantation (LT) recipients in our program are transferred from operating room to postanesthesia care unit for recovery and extubation with transfer to the ward, completely eliminating an intensive care unit (ICU) stay. Developing a reliable method to determine patients suitable for fast-tracking would be of practical benefit to centers considering this practice. The aim of this study was to create a fast-tracking probability score that could be used to predict successful assignment of care location after LT. Recipient, donor and operative characteristics were assessed for independent association with successful fast-tracking to create a probability score. Of the 1296 LT recipients who met inclusion criteria, 704 (54.3%) were successfully fast-tracked and 592 (45.7%) were directly admitted to the ICU after LT. Based on nine readily available variables at the time of LT, we created a scoring system that classified patients according to the likelihood of being successfully fast-tracked to the surgical ward, with an area under the curve (AUC) of 0.790 (95% CI: 0.765-0.816). This score was validated in an independent group of 372 LT with similar AUC. We describe a score that can be used to predict successful fast-tracking immediately after LT using readily available clinical variables. The authors describe their experience of avoiding stay in the intensive care unit after liver transplantation and propose a scoring system to assign location of care using readily available clinical variables.

Original languageEnglish (US)
Pages (from-to)2088-2096
Number of pages9
JournalAmerican Journal of Transplantation
Volume14
Issue number9
DOIs
StatePublished - 2014

Fingerprint

Liver Transplantation
Intensive Care Units
Area Under Curve
Operating Rooms
Tissue Donors

Keywords

  • Clinical research
  • hepatology
  • liver transplantation
  • patient safety
  • patient survival
  • practice

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)
  • Medicine(all)

Cite this

Bulatao, I. G., Heckman, M. G., Rawal, B., Aniskevich, S., Shine, T. S., Keaveny, A. P., ... Taner, C. B. (2014). Avoiding stay in the intensive care unit after liver transplantation: A score to assign location of care. American Journal of Transplantation, 14(9), 2088-2096. https://doi.org/10.1111/ajt.12796

Avoiding stay in the intensive care unit after liver transplantation : A score to assign location of care. / Bulatao, I. G.; Heckman, M. G.; Rawal, B.; Aniskevich, S.; Shine, T. S.; Keaveny, A. P.; Perry, D. K.; Canabal, J.; Willingham, D. L.; Taner, C. B.

In: American Journal of Transplantation, Vol. 14, No. 9, 2014, p. 2088-2096.

Research output: Contribution to journalArticle

Bulatao, IG, Heckman, MG, Rawal, B, Aniskevich, S, Shine, TS, Keaveny, AP, Perry, DK, Canabal, J, Willingham, DL & Taner, CB 2014, 'Avoiding stay in the intensive care unit after liver transplantation: A score to assign location of care', American Journal of Transplantation, vol. 14, no. 9, pp. 2088-2096. https://doi.org/10.1111/ajt.12796
Bulatao, I. G. ; Heckman, M. G. ; Rawal, B. ; Aniskevich, S. ; Shine, T. S. ; Keaveny, A. P. ; Perry, D. K. ; Canabal, J. ; Willingham, D. L. ; Taner, C. B. / Avoiding stay in the intensive care unit after liver transplantation : A score to assign location of care. In: American Journal of Transplantation. 2014 ; Vol. 14, No. 9. pp. 2088-2096.
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