Evidence map›Paper›PMID 33912659›Full record

ArticleTransplantation direct2021

Understanding the Impact of Pneumonia and Other Complications in Elderly Liver Transplant Recipients: An Analysis of NSQIP Transplant.

Gabriel T Schnickel, Stuart Greenstein, Jennifer A Berumen, Nahel Elias, Debra L Sudan, Kendra D Conzen, Kristin L Mekeel, David P Foley, Ryutaro Hirose, Justin R Parekh

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation direct, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Gabriel T SchnickelDivision of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
Stuart GreensteinMontefiore Einstein Center for Transplantation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Jennifer A BerumenDivision of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
Nahel EliasHarvard Medical School, Boston, MA.
Debra L SudanDivision of Abdominal Transplant Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Kendra D ConzenDivision of Transplant Surgery, University of Colorado School of Medicine, Aurora, CO.
Kristin L MekeelDivision of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
David P FoleyUniversity of Wisconsin, School of Medicine and Public Health, Madison, WI.
Ryutaro HiroseUniversity of California San Francisco, San Francisco, CA.
Justin R ParekhDivision of Transplant and Hepatobiliary Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
Duke Medical Center · USMassachusetts General Hospital · USUniversity of California, San Francisco · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite an increasing demand for liver transplantation in older patients, our understanding of posttransplant outcomes in older recipients is limited to basic recipient and graft survival. Using National Surgical Quality Improvement Program Transplant, we tracked early outcomes after liver transplantation for patients >65.

methodsWe conducted a retrospective analysis of patients in National Surgical Quality Improvement Program Transplant between March 1, 2017 and March 31, 2019. Recipients were followed for 1 y after transplant with follow-up at 30, 90, and 365 d. Data were prospectively gathered using standard definitions across all sites.

resultsOne thousand seven hundred thirty-one adult liver transplants were enrolled; 387 (22.4%) were >65 y old. The majority of older recipients were transplanted for hepatocellular carcinoma. The older cohort had a lower lab Model for End-Stage Liver Disease and was less likely to be hospitalized at time of transplant. Overall, older recipients had higher rates of pneumonia but no difference in intensive care unit length of stay (LOS), total LOS, surgical site infection, or 30-d readmission. Subgroup analysis of patients with poor functional status revealed a significant difference in intensive care unit and total LOS. Pneumonia was even more common in older patients and had a significant impact on overall survival.

conclusionsBy targeting patients with hepatocellular carcinoma and lower Model for End-Stage Liver Diseases, transplant centers can achieve nearly equivalent outcomes in older recipients. However, older recipients with poor functional status require greater resources and are more likely to develop pneumonia. Pneumonia was strongly associated with posttransplant survival and represents an opportunity for improvement. By truly understanding the outcomes of elderly and frail recipients, transplant centers can improve outcomes for these higher-risk recipients.

Identifiers

PMID33912659
PMCPMC8078357
OpenAlexW3159135088

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.