Article ; Online: Incidence, Outcomes, and Risk Factors of Intraoperative Cardiac Arrest During Orthotopic Liver Transplantation.
2024 Volume 56, Issue 3, Page(s) 608–612
Abstract: Background: Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is a rare surgical complication that results in devastating outcomes. Moreover, previous worldwide studies have found inconsistencies in the risk factors associated with ... ...
| Abstract | Background: Intraoperative cardiac arrest (ICA) during liver transplantation (LT) is a rare surgical complication that results in devastating outcomes. Moreover, previous worldwide studies have found inconsistencies in the risk factors associated with ICA in LT. Methods: This was a retrospective cohort study of adult patients who underwent LT between January and October 2021 at Siriraj Hospital, a tertiary care hospital. The incidence of ICA and outcomes of patients who experienced ICA were examined. Risk factors associated with ICA were investigated as a secondary objective. Results: Among 342 patients, the incidence of ICA was 3.5% (95% CI 1.8%-6.1%). Of these, 33.3% died intraoperatively. Among patients with ICA, 41.7% died within 30 days, compared with only 7.6% in those without ICA (P = .002). Moreover, the in-hospital mortality rate of those with ICA was 58.3%, which was significantly higher than that of those without ICA (9.7%, P < .001). However, 41.7% of patients with ICA were discharged alive with long-term survival. Because ICA is a rare event, we found only 2 independent factors significantly associated with ICA. These factors include intraoperative temperature below 35°C, with an odds ratio (OR) of 6.07 (95% CI:1.32-27.88, P = .02) and elevated intraoperative serum potassium, with an OR of 4.57 (95% CI:2.15-9.67, P < .001). Conclusions: ICA is associated with high perioperative and in-hospital mortality. However, our findings suggest that with effective management of ICA, more than 40% of these patients could be discharged with excellent long-term outcomes. Hypothermia and hyperkalemia were independent risk factors significantly associated with ICA. |
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| MeSH term(s) | Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Heart Arrest/epidemiology ; Heart Arrest/etiology ; Risk Factors ; Male ; Retrospective Studies ; Female ; Middle Aged ; Incidence ; Intraoperative Complications/epidemiology ; Hospital Mortality ; Adult ; Treatment Outcome ; Aged | |||||
| Language | English | |||||
| Publishing date | 2024-02-10 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 82046-5 | |||||
| ISSN | 1873-2623 ; 0041-1345 | |||||
| ISSN (online) | 1873-2623 | |||||
| ISSN | 0041-1345 | |||||
| DOI | 10.1016/j.transproceed.2024.01.029 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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