Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.743
Peer-review started: June 28, 2016
First decision: August 5, 2016
Revised: October 8, 2016
Accepted: November 1, 2016
Article in press: November 3, 2016
Published online: December 24, 2016
Processing time: 172 Days and 5 Hours
To explore the effect of primary liver disease and comorbidities on transplant length of stay (TLOS) and LOS in later admissions in the first two years after liver transplantation (LLOS).
A linked United Kingdom Liver Transplant Audit - Hospital Episode Statistics database of patients who received a first adult liver transplant between 1997 and 2010 in England was analysed. Patients who died within the first two years were excluded from the primary analysis, but a sensitivity analysis was also performed including all patients. Multivariable linear regression was used to evaluate the impact of primary liver disease and comorbidities on TLOS and LLOS.
In 3772 patients, the mean (95%CI) TLOS was 24.8 (24.2 to 25.5) d, and the mean LLOS was 24.2 (22.9 to 25.5) d. Compared to patients with cancer, we found that the largest difference in TLOS was seen for acute hepatic failure group (6.1 d; 2.8 to 9.4) and the largest increase in LLOS was seen for other liver disease group (14.8 d; 8.1 to 21.5). Patients with cardiovascular disease had 8.5 d (5.7 to 11.3) longer TLOS and 6.0 d (0.2 to 11.9) longer LLOS, compare to those without. Patients with congestive cardiac failure had 7.6 d longer TLOS than those without. Other comorbidities did not significantly increase TLOS nor LLOS.
The time patients spent in hospital varied according to their primary liver disease and some comorbidities. Time spent in hospital of patients with cancer was relatively short compared to most other indications. Cardiovascular disease and congestive cardiac failure were the comorbidities with a strong impact on increased LOS.
Core tip: Time patients spent in hospital in transplant admission and in later admissions after liver transplantation may reflect the success of liver transplantation. By analysing a linked United Kingdom Liver Transplant Audit - Hospital Episode Statistics database between 1997 and 2010, we found that average transplant length of stay (LOS) was 24.8 d, and mean LOS of all admissions in the first two years after transplantation was 24.2 d. Primary liver disease and comorbidities had a significant impact on LOS. Patients transplanted for cancer has shorter LOS compared to other indications. Cardiovascular disease and congestive cardiac failure were associated with increased LOS.