Background: Survival after cardiac transplantation has not changed over the last 10 years. Our objective was to identify risk factors for 30-day mortality after cardiac transplantation with particular reference to focusing on the impact of pre-existing renal dysfunction.
Methods: We analyzed the data of all 1,180 patients who received a first heart transplant in the 8 adult transplant centers in the United Kingdom between April 1996 and March 2002 using the UK Cardiothoracic Transplant Audit database. Renal function at registration and transplantation was determined by calculation of creatinine clearance (CrCl) according to the Cockcroft-Gault formula.
Results: Multivariate analysis showed that ventilator dependence pre-transplantation and cold ischemia time >4 hours had the highest association with 30-day mortality, followed by CrCl =50 ml/min. Patients with a CrCl =50 ml/min on day of transplantation had a significantly higher 30-day mortality compared to patients with CrCl >50 ml/min (19.7% vs 9.5%; p < 0.01). The change in CrCl between registration and transplantation was not related to mean CrCl or waiting time. In 67 of the patients with a CrCl >50 ml/min at registration, CrCl was reduced to =50 ml/min on day of transplantation (30-day mortality 16.7%).
Conclusions: Pre-operative CrCl =50 ml/min doubles the risk of death within 30 days after cardiac transplantation. Patients considered for cardiac transplantation should undergo regular measurement of renal function so that a more accurate risk-benefit assessment can be made.
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http://dx.doi.org/10.1016/j.healun.2003.09.006 | DOI Listing |
J Neurosurg Pediatr
January 2025
4Department of Neurosurgery, Children's Hospital Colorado Anschutz Medical Campus, Aurora; and.
Objective: Pediatric traumatic brain injury (TBI) represents a significant public health concern and source of resource utilization. The aim of this study was to establish the ability of the previously published pediatric Brain Injury Guidelines (pBIG) to identify patients with traumatic intracranial hemorrhage (ICH) who might not require routine repeat neuroimaging, neurosurgical consultation, or hospital admission in a large level I and level II trauma cohort.
Methods: Pediatric patients who presented with traumatic ICH between 2018 and 2022 at the included institutions were retrospectively reviewed and sorted into pBIG categories using clinical and radiographic criteria.
Circ Cardiovasc Qual Outcomes
January 2025
Division of Cardiology, Department of Medicine, University of Washington, Seattle (J.A.D., E.J.S., D.H.A.).
Background: Case-based peer review of percutaneous coronary intervention (PCI) is used by many hospitals for quality improvement and to make decisions regarding physician competency. However, there are no studies testing the reliability or validity of peer review for PCI performance evaluation.
Methods: We recruited interventional cardiologists from 12 Veterans Affairs Health System facilities throughout the United States to provide PCI cases for review.
Health Inf Sci Syst
December 2025
Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, Singapore, Singapore.
Purpose: Real-time risk monitoring is critical but challenging in intensive care units (ICUs) due to the lack of real-time updates for most clinical variables. Although real-time predictions have been integrated into various risk monitoring systems, existing systems do not address uncertainties in risk assessments. We developed a novel framework based on commonly used systems like the Sequential Organ Failure Assessment (SOFA) score by incorporating uncertainties to improve the effectiveness of real-time risk monitoring.
View Article and Find Full Text PDFAnn Acad Med Singap
December 2024
Department of Surgery, Ng Teng Fong General Hospital, Singapore.
Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single centre.
Method: A prospective cohort study was conducted from August 2020 to July 2023.
Sci Rep
January 2025
Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
The Triglyceride glucose (TyG) index is a dependable indicator of IR, with numerous studies underscoring its influence on Cardiovascular disease. Nevertheless, the connection between the TyG index and prognosis in AMI patients after PCI is still uncertain. This investigation aims to explore the link in individuals who have received PCI for AMI.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!