Pretransplant Coagulopathy and In-hospital Outcomes Among Heart Transplant Recipients: A Propensity-Matched Nationwide Inpatient Sample Study

被引：10

作者：

Mujib, Marjan ^{[1
]}

Khanna, Neel ^{[2
]}

Mazumder, Nabila K. ^{[3
]}

Aronow, Wilbert S. ^{[2
]}

Kolte, Dhaval ^{[1
]}

Khera, Sahil ^{[2
]}

Palaniswamy, Chandrasekar ^{[4
]}

Jain, Diwakar ^{[2
]}

Lanier, Gregg M. ^{[2
]}

Sule, Sachin ^{[1
]}

Ahmed, Ali ^{[5
]}

Levy, Wayne C. ^{[6
]}

Prabhu, Sumanth D. ^{[7
]}

Cooper, Howard A. ^{[2
]}

Panza, Julio A. ^{[2
]}

Gass, Alan L. ^{[2
]}

Fonarow, Gregg C. ^{[8
]}

机构：

[1] New York Med Coll, Dept Med, Valhalla, NY 10595 USA

[2] New York Med Coll, Div Cardiol, Valhalla, NY 10595 USA

[3] Flushing Hosp & Med Ctr, Med Ctr, Dept Med, Flushing, NY USA

[4] Mt Sinai Med Ctr, Dept Med, Div Cardiol, New York, NY 10029 USA

[5] Washington DC VA Med Ctr, Dept Med, Washington, DC USA

[6] Univ Washington, Div Cardiol, Seattle, WA 98195 USA

[7] Univ Alabama Birmingham, Div Cardiovasc Dis, Birmingham, AL USA

[8] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Cardiol, Los Angeles, CA 90095 USA

来源：

CLINICAL CARDIOLOGY | 2015年 / 38卷 / 05期

关键词：

VENTRICULAR ASSIST DEVICE; INTERNATIONAL SOCIETY; COMORBIDITY MEASURES; CARDIAC-SURGERY; THROMBOCYTOPENIA; SCORE; INFORMATION; DYSFUNCTION; MORTALITY; REGISTRY;

D O I：

10.1002/clc.22391

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundThe prevalence and contemporary trends of pre-heart transplantation (HT) coagulopathy and associated clinical outcomes have not been studied from a national database. HypothesisPre-HT coagulopathy is associated with increased in-hospital mortality. MethodsAmong 2454 adult HT recipients from the 2003 to 2010 Nationwide Inpatient Sample databases, 707 (29%) had pre-HT coagulopathy (defined as a comorbidity variable, based on International Classification of Diseases, Ninthe Revision, Clinical Modification and Diagnosis Related Group codes). We used propensity scores for coagulopathy to assemble a matched cohort of 664 pairs of patients with and without coagulopathy balanced in 54 baseline characteristics. ResultsThe prevalence of pre-HT coagulopathy increased from 17% in 2003 to 44% in 2010 (P for trend <0.001). In-hospital mortality occurred in 8.6% and 4.7% of matched HT recipients with and without coagulopathy, respectively (hazard ratio: 1.81; 95% confidence interval [CI]: 1.17-2.80; P = 0.008). Coagulopathy was not significantly associated with post-HT graft complications (odds ratio [OR]: 1.20; 95% CI: 0.95-1.52; P = 0.131) but was associated with increased blood transfusions (OR: 1.92; 95% CI, 1.54-2.41; P < 0.001). Coagulopathy and no-coagulopathy groups had no difference in median length of stay (22 days in each group, P = 0.746), but median total hospital charges were higher among patients with coagulopathy compared to those without (US$425 643 vs US$389 656; P = 0.008). ConclusionsIn this national study of HT recipients, pretransplant coagulopathy was common, increased over time, and was not significantly associated with post-HT graft complications or increased hospital stay. However, it was associated with increased bleeding risk, in-hospital mortality, and total hospital charges. These findings may have implications for the selection of patients for HT.

引用

页码：300 / 308

页数：9

共 37 条

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