Recent alcohol use prolongs hospital length of stay following lung transplant

Lowery, Erin M.; Yong, Meagan; Cohen, Arala; Joyce, Cara; Kovacs, Elizabeth J.

doi:10.1111/ctr.13250

Cited by 11 publications

(4 citation statements)

References 31 publications

(80 reference statements)

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“…91 Posttransplant nutritional management challenges in these highly catabolic patients were described by Jomphe et al 92 Active casual alcohol use prevalence was about 1 in 3 prior to transplantation and was associated with a 300% increase in mechanical ventilation time and ICU stay and a 150% increase in hospital stay, but mortality and graft function outcomes were not statistically different. 93 E-cigarette use increased in this population. 94 Diabetes was extremely common in waitlisted patients (>40%) and even higher in CF waitlisted patients (>90%).…”

Section: Lung Transplantationmentioning

confidence: 82%

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation

Tawil

Adams

Nicoara

et al. 2019

Semin Cardiothorac Vasc Anesth

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Publications of note from 2018 are reviewed for the cardiothoracic transplant anesthesiologist. Strategies to expand the availability of donor organs were highlighted, including improved donor management, accumulating experience with increased-risk donors, ex vivo perfusion techniques, and donation after cardiac death. A number of reports examined posttransplant outcomes, including outcomes other than mortality, with new data-driven risk models. Use of extracorporeal support in cardiothoracic transplantation was a prominent theme. Major changes in adult heart allocation criteria were implemented, aiming to improve objectivity and transparency in the listing process. Frailty and prehabilitation emerged as targets of comprehensive perioperative risk mitigation programs.

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Section: Lung Transplantationmentioning

confidence: 82%

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation

Tawil

Adams

Nicoara

et al. 2019

Semin Cardiothorac Vasc Anesth

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“…In a review of depression and postoperative complications, Ghoneim and O'Hara suggested several potential causes for this linkage, including association with unhealthy lifestyle, decreased compliance with medical recommendations, and tendency to seek intervention at later stages of illness [28]. Factors such as alcohol abuse, smoking, and drug abuse are known predictors of poor outcomes in surgery [28][29][30][31]. Here, although we observed higher rates of them among individuals with a history of depression, its association with mortality remained even after adjusting for these factors.…”

Section: Ta B L Ementioning

confidence: 99%

History of depression is associated with worsened postoperative outcomes following colectomy

et al. 2021

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Aim Depression is a prevalent disorder that is associated with adverse health outcomes, but an understanding of its effect in colorectal surgery remains limited. The purpose of this study was to examine the impact of history of depression among patients undergoing colectomy. Method United States patients from Marketscan (2010–2017) who underwent colectomy were included and stratified by whether they had a history of depression within the past year, defined as (1) a diagnosis of depression during the index admission, (2) a diagnosis of depression during any inpatient or (3) outpatient admission within the year, and/or (4) a pharmacy claim for an antidepressant within the year. The primary outcomes were length of stay (LOS) and inpatient hospital charge. Secondary outcomes included in‐hospital mortality and postoperative complications. Logistic, negative binomial, and quantile regressions were performed. Results Among 88 981 patients, 21 878 (24.6%) had a history of depression. Compared to those without, patients with a history of depression had significantly longer LOS (IRR = 1.06, 95% CI [1.05, 1.07]), increased inpatient charge (β = 467, 95% CI [167, 767]), and increased odds of in‐hospital mortality (OR = 1.37, 95% CI [1.08, 1.73]) after adjustment. History of depression was also independently associated with increased odds of respiratory complication, pneumonia, and delirium (all P < 0.05). Conclusion History of depression was prevalent among individuals undergoing colectomy, and associated with greater mortality and inpatient charge, longer LOS, and higher odds of postoperative complication. These findings highlight the impact of depression in colorectal surgery patients and suggest that proper identification and treatment may reduce postoperative morbidity.

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“…Each avoidable postoperative complication costs an additional $20,000 in healthcare dollars (Healy et al., 2016). Individuals with risky alcohol use and alcohol use disorders utilize the largest proportion of healthcare resources after surgery due to complications, increased hospital length of stay, and post‐operative readmissions (Graham et al., 2019; Healy et al., 2016; Lowery et al., 2018; Spies et al., 1996).…”

Section: Introductionmentioning

confidence: 99%

Automated‐detection of risky alcohol use prior to surgery using natural language processing

Vydiswaran,

Strayhorn,

Weber

et al. 2024

Alcohol: Clinical and Experimental Research

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BackgroundPreoperative risky alcohol use is one of the most common surgical risk factors. Accurate and early identification of risky alcohol use could enhance surgical safety. Artificial Intelligence‐based approaches, such as natural language processing (NLP), provide an innovative method to identify alcohol‐related risks from patients' electronic health records (EHR) before surgery.MethodsClinical notes (n = 53,629) from pre‐operative patients in a tertiary care facility were analyzed for evidence of risky alcohol use and alcohol use disorder. One hundred of these records were reviewed by experts and labeled for comparison. A rule‐based NLP model was built, and we assessed the clinical notes for the entire population. Additionally, we assessed each record for the presence or absence of alcohol‐related International Classification of Diseases (ICD) diagnosis codes as an additional comparator.ResultsNLP correctly identified 87% of the human‐labeled patients classified with risky alcohol use. In contrast, diagnosis codes alone correctly identified only 29% of these patients. In terms of specificity, NLP correctly identified 84% of the non‐risky cohort, while diagnosis codes correctly identified 90% of this cohort. In the analysis of the full dataset, the NLP‐based approach identified three times more patients with risky alcohol use than ICD codes.ConclusionsNLP, an artificial intelligence‐based approach, efficiently and accurately identifies alcohol‐related risk in patients' EHRs. This approach could supplement other alcohol screening tools to identify patients in need of intervention, treatment, and/or postoperative withdrawal prophylaxis. Alcohol‐related ICD diagnosis had limited utility relative to NLP, which extracts richer information within clinical notes to classify patients.

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Recent alcohol use prolongs hospital length of stay following lung transplant

Cited by 11 publications

References 31 publications

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation

History of depression is associated with worsened postoperative outcomes following colectomy

Automated‐detection of risky alcohol use prior to surgery using natural language processing

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