Non-Home Discharge is Not Associated with Mortality Following Bilateral Lung Transplant

Heid, Christopher A.; Khoury, Mitri K.; R, Vela; Maaraoui, Kayla; Liu, C.; Pruszynski, Jessica; Ring, W. Steves; Wait, Michael A.; Huffman, Lynn C.; Peltz, Matthias

doi:10.1016/j.healun.2020.01.500

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“…At our institution, most nonhome discharges following lung transplant are to an affiliated adjacent inpatient rehabilitation center whereby our surgeons and pulmonologist can continue to participate in the patient's care. It is possible our success in managing patients that require a nonhome discharge may be one reason for better long‐term outcomes in this study 12 …”

Section: Discussionmentioning

confidence: 82%

“…outcomes in this study. 12 The incidence of CVA following LT is higher than that of the typical perioperative patient. Compared to general and vascular surgical procedures, where reports as low as 0.08% of patients experience postoperative CVA have been published, patients undergoing LT experienced a higher incidence of CVA and are comparable to patients undergoing cardiac surgery (3.8%).…”

Section: Baseline Characteristics Are Shown Inmentioning

confidence: 99%

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Impact of cerebrovascular accidents on lung transplant survival

Kalsbeek

Chuckaree

Khoury

et al. 2022

Journal of Cardiac Surgery

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Background: Cerebrovascular accidents (CVA) are a source of postoperative morbidity. Existing data on CVA after lung transplantation (LT) are limited. We aimed to evaluate the impact of CVA on LT survival. Methods: A retrospective analysis of LT recipients at the University of Texas Southwestern Medical Center was performed. Data was obtained from the institutional thoracic transplant database between January 2012 and December 2018, which consisted of 476 patients. Patients were stratified by the presence of a postoperative CVA. Univariate comparisons of baseline characteristics, operative variables, and postoperative outcomes between the cohorts were performed.Survival was analyzed by Kaplan-Meier method. Aalen's additive regression model was utilized to assess mortality hazard over time.Results: The incidence of CVA was 4.2% (20/476). Lung allocation score was higher in the CVA cohort (46.2 [41.7, 57.3] vs. 41.5 [35.8, 52.2], p = 0.04). There were no significant differences in operative variables. CVA patients had longer initial intensive care unit (ICU) stays (316 h [251, 557] vs. 124 [85, 218], p < 0.001) and longer length of stay (22 days [17, 53] vs. 15 [11, 26], p = 0.007). CVA patients required more ICU readmissions (35% vs. 15%, p = 0.02) and had a lower rates of home discharge (35% vs. 71%, p < 0.001). Thirty-day mortality was higher in the CVA cohort (20% vs. 1.3%, p < 0.001). Overall survival was lower in the CVA cohort (log rank p = 0.044).Conclusions: Postoperative CVA following LT was associated with longer ICU stays, more ICU readmissions, longer length of stay, and fewer home discharges. Thirty day and long-term mortality were significantly higher in the CVA group.

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Section: Discussionmentioning

confidence: 82%

Section: Baseline Characteristics Are Shown Inmentioning

confidence: 99%