Use of a severity indicator as a predictor of the use of hepatic transplantation resources

Abstract

OBJECTIVE To evaluate the use of a severity indicator for end-stage liver disease as a predictor of resource use in a teaching hospital in São Paulo. METHOD Descriptive, retrospective study, classifying independent variables in seven key dimensions: identification/risk rating; length of stay/use of advanced life support; imaging; clinical analysis; special procedures; blood products in the intensive care unit; and in the operating room. The frequencies were analyzed by linear regression analysis of variance to detect relevance due to the dependent variable (severity indicator) in 76 cases seen in 2013. RESULTS Among the variables studied, those that presented relevance due to the functional risk score were laboratory measurements of bilirubin, amylase, transaminase, blood count, creatine phosphokinase (p<0.05), hemotherapy procedures fresh frozen plasma (FFP) and platelet concentrate (p<0.05), and Doppler echocardiography image (p<0.07). CONCLUSION Given the results/objective of this study, it is concluded that the indicator presents a potential predictive capability in the use of postoperative resources of liver receptors in the size, clinical analysis, images and hemotherapy dimensions.

Perspectivas da fila de espera por um transplante hepático no Paraná: uma revisão de literatura

“…Trata-se de uma revisão de literatura, com desenho narrativo, dividida em duas etapas: (i) a revisão da literatura científica especializada, mediante busca nas bases Austrália e Nova Zelândia 17,19 . Por fim, o segundo escore envolve os critérios de Milão, que são usados para portadores de câncer hepatocelular 7 .…”

Safe surgery checklist: content validation proposal for liver transplantation

“…Studies indicate the verification of laboratory tests as a safety criterion in anesthetic induction, making it possible to take actions as soon as possible to reverse certain problems (16)(17) . In liver transplantation, anesthetic induction ensures a stable transoperative, a more peaceful anepathic and neohepatic phase, in addition to an effective reperfusion considering the control performed by the anesthesiologist (18)(19)(20) . With regard to checking, the moment "Before starting the surgery", which underwent the greatest number of adjustments and inclusion of items, the evidence brought data related to body temperature and use of devices (12)(13)(14)(15) .…”

“…Bearing in mind that the Liver Transplant surgery time is prolonged, between six and ten hours, considering the effects of anesthesia on respiratory mechanics, lung volumes and gas exchange, in addition to the effects of the anepathic and neohepatic phase in the body, the devices allow monitoring of hemodynamics and help to assess and assume appropriate and immediate procedures preventing risk and damage to the patient (24)(25)(26) . The use of devices and equipment in Liver Transplant are extremely important to promote agility and safety during the operation (16)(17)20) . There are recommendations that, in major surgeries, devices should be installed, as well as maintaining a temperature above 36 °C to promote hemodynamic stability (27) .…”

Infecções Relacionadas À Assistência À Saúde E Fatores Associados No Pós-Operatório De Transplante Hepático

“…1 The survival rates of adult patients in Europe, one and five years after the LT are 62% and 81%; and in the United States, 86.9% and 73.4%, respectively.…”