Risk factors for mortality after laparotomy for hemorrhage in patients with bleeding after liver transplantation
10.3760/cma.j.issn.0254-1416.2020.02.004
- VernacularTitle:肝移植术后出血患者开腹止血术后死亡的危险因素
- Author:
Xiao HUANG
1
;
Changwei WEI
;
Anshi WU
Author Information
1. 首都医科大学附属北京朝阳医院麻醉科 100020
- From:
Chinese Journal of Anesthesiology
2020;40(2):140-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for mortality after laparotomy for hemorrhage in the patients with bleeding after liver transplantation.Methods:The patients who underwent re-laparotomy for hemorrhage after liver transplantation, aged>18 yr, from June 2005 to June 2013, were selected.The preoperative clinical characteristics of patients, time of liver transplantation, mode of operation, intraoperative massive hemorrhage, intraoperative use of vasoactive drugs, atropine, lidocaine and immunosuppressive agents, and postoperative tracheotomy and renal failure were collected.Patients were divided into survival group (group S) and death group (group D) according to the survival outcome at 3 months after surgery.Factors of which P values were less than 0.05 would enter the multiple logistic regression analysis to stratify the risk factors for mortality of patients with bleeding after liver transplantation. Results:A total of 128 patients were included in this study , with 117 cases in group S and 11 cases in group D. Postoperative renal failure was the independent risk factor for mortality of patients with bleeding after liver transplantation, and OR value (95% confidence interval) was 11.307 (1.992-64.188) ( P<0.05). The area under the curve of postoperative renal failure (95% confidence interval) was 0.849 (0.712-0.986), and the sensitivity and specificity were 81.8% and 12.0%, respectively. Conclusion:Postoperative renal failure is an independent risk factor for mortality after laparotomy for hemorrhage in the patients with bleeding after liver transplantation.
