Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec 24;6(4):743-750.
doi: 10.5500/wjt.v6.i4.743.

Time spent in hospital after liver transplantation: Effects of primary liver disease and comorbidity

Chutwichai Tovikkai  1 , Susan C Charman  1 , Raaj K Praseedom  1 , Alexander E Gimson  1 , Jan van der Meulen  1
Affiliations

Time spent in hospital after liver transplantation: Effects of primary liver disease and comorbidity

Chutwichai Tovikkai et al. World J Transplant. .

Abstract

Aim: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Comorbidity; Hospital stay; Length of stay; Liver transplantation.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Adjusted transplant length of stay and length of stay in later admissions in the first 2 years after liver transplantation according to primary liver disease. HCV: Hepatitis C cirrhosis; PSC: Primary sclerosing cholangitis; HBV: Hepatitis B cirrhosis; PBC: Primary biliary cirrhosis; ALD: Alcoholic liver disease; AIH: Autoimmune hepatitis and cryptogenic cirrhosis; LOS: Length of stay.
See this image and copyright information in PMC

References

    1. Showstack J, Katz PP, Lake JR, Brown RS, Dudley RA, Belle S, Wiesner RH, Zetterman RK, Everhart J. Resource utilization in liver transplantation: effects of patient characteristics and clinical practice. NIDDK Liver Transplantation Database Group. JAMA. 1999;281:1381–1386. - PubMed
    1. Markmann JF, Markmann JW, Desai NM, Baquerizo A, Singer J, Yersiz H, Holt C, Ghobrial RM, Farmer DG, Busuttil RW. Operative parameters that predict the outcomes of hepatic transplantation. J Am Coll Surg. 2003;196:566–572. - PubMed
    1. Bucuvalas JC, Zeng L, Anand R. Predictors of length of stay for pediatric liver transplant recipients. Liver Transpl. 2004;10:1011–1017. - PubMed
    1. Washburn WK, Meo NA, Halff GA, Roberts JP, Feng S. Factors influencing liver transplant length of stay at two large-volume transplant centers. Liver Transpl. 2009;15:1570–1578. - PubMed
    1. Smith JO, Shiffman ML, Behnke M, Stravitz RT, Luketic VA, Sanyal AJ, Heuman DM, Fisher RA, Cotterell AH, Maluf DG, et al. Incidence of prolonged length of stay after orthotopic liver transplantation and its influence on outcomes. Liver Transpl. 2009;15:273–279. - PubMed

LinkOut - more resources