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Liver transplant length of stay ( LOS ) index: A novel predictive score for hospital length of stay following liver transplantation
Author(s) -
Rana Abbas,
Witte Ellen D.,
Halazun Karim J.,
Sood Gagan K.,
Mindikoglu Ayse L.,
Sussman Norman L.,
Vierling John M.,
Kueht Michael L.,
Galvan Nhu Thao N.,
Cotton Ronald T.,
O'Mahony Christine A.,
Goss John A.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13141
Subject(s) - medicine , liver transplantation , odds ratio , intensive care unit , transplantation , univariate analysis , emergency medicine , multivariate analysis , population , cohort , risk factor , imputation (statistics) , intensive care medicine , missing data , statistics , environmental health , mathematics
An index to predict hospital length of stay after liver transplantation could address unmet clinical needs. Length of stay is an important surrogate for hospital costs and efforts to limit stays can preserve our healthcare resources. Here, we devised a scoring system that predicts hospital length of stay following liver transplantation. We used univariate and multivariate analyses on 73 635 adult liver transplant recipient data and identified independent recipient and donor risk factors for prolonged hospital stay (>30 days). Multiple imputation was used to account for missing variables. We identified 22 factors as significant predictors of prolonged hospital stay, including the most significant risk factors: intensive care unit ( ICU ) admission ( OR 1.75, CI 1.58‐1.95) and previous transplant ( OR 1.60, CI 1.47‐1.75). The length of stay ( LOS ) index assigns weighted risk points to each significant factor in a scoring system to predict prolonged hospital stay after liver transplantation with a c‐statistic of 0.75. The LOS index demonstrated good discrimination across the entire population, dividing the cohort into tertiles, which had odds ratios of 2.25 ( CI 2.06‐2.46) and 7.90 (7.29‐8.56) for prolonged hospital stay (>30 days). The LOS index utilizes 22 significant donor and recipient factors to accurately predict hospital length of stay following liver transplantation. The index further demonstrates the basis for a clear clinical recommendation to mitigate risk of long hospitalization by minimizing cold ischemia time.