Clinical Outcomes and Risk Factors of Heart Transplantation Patients Experiencing Gastrointestinal Bleeding
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients and Study Design
2.2. Data Collection, Variable Definitions, and Grouping
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Postoperative GIB and Survival in HT Patients
3.3. Risk Factors of Postoperative GIB in HT Patients
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Non-GIB (n = 421) | GIB (n = 40) | p Values | |
---|---|---|---|
Age (years) | 50.00 (39.00–57.00) | 54.50 (47.50–58.00) | 0.024 |
Gender, male (%) | 84 (20.0) | 11 (27.5) | 0.259 |
BMI (kg/m2) | 23.02 ± 3.97 | 22.02 ± 2.89 | 0.120 |
Blood type | 0.774 | ||
A, n (%) | 146 (34.7) | 12 (30.0) | |
B, n (%) | 116 (27.6) | 11 (27.5) | |
AB, n (%) | 31 (7.4) | 2 (5.0) | |
O, n (%) | 128 (30.4) | 15 (37.5) | |
Current smoking, n (%) | 174 (41.3) | 12 (30.0) | 0.163 |
Current drinking, n (%) | 116 (27.6) | 7 (17.5) | 0.170 |
Medical history | |||
Hypertension, n (%) | 70 (16.6) | 3 (7.5) | 0.131 |
Hyperlipemia, n (%) | 28 (6.7) | 0 (0.0) | 0.157 |
Diabetes, n (%) | 85 (20.2) | 8 (20.0) | 0.977 |
Gastrointestinal disease, n (%) | 48 (11.4) | 5 (12.5) | 0.796 |
NYHA classification | 0.932 | ||
II, n (%) | 1 (0.2) | 0 (0.0) | |
III, n (%) | 18 (4.3) | 2 (5.0) | |
IV, n (%) | 402 (95.5) | 38 (95.0) | |
Cardiac operation, n (%) | 121 (28.7) | 17 (42.5) | 0.069 |
Dialysis, n (%) | 4 (1.0) | 0 (0.0) | 1.000 |
Preoperative data | |||
RBC (×1012/L) | 4.49 (4.08–4.89) | 4.16 (3.72–4.69) | 0.004 |
Hb (g/L) | 138.00 (122.00–149.00) | 127.50 (105.75–141.25) | 0.004 |
WBC (×109/L) | 6.36 (4.96–8.00) | 5.97 (4.46–6.93) | 0.089 |
PLT (×109/L) | 172.50 (138.25–221.75) | 173.00 (119.25–235.25) | 0.782 |
albumin (g/L) | 39.50 (36.60–42.30) | 37.90 (34.90–40.30) | 0.025 |
AST (mmol/L) | 28.00 (21.00–41.00) | 26.00 (18.25–38.00) | 0.737 |
ALT (mmol/L) | 28.00 (18.00–46.00) | 23.50 (13.25–44.75) | 0.226 |
TBIL (mmol/L) | 22.00 (14.20–33.50) | 27.05 (13.68–40.85) | 0.737 |
Cr (μmol/L) | 88.65 (72.43–108.33) | 87.35 (72.65–119.78) | 0.996 |
BUN (mmol/L) | 7.31 (5.84–9.57) | 7.55 (6.30–11.09) | 0.291 |
TG (mmol/L) | 1.06 (0.78–1.43) | 0.95 (0.74–1.29) | 0.381 |
LDL-C (mmol/L) | 2.14 (1.69–2.63) | 2.09 (1.61–2.76) | 0.876 |
APTT (s) | 39.00 (36.20–43.25) | 40.60 (38.18–46.50) | 0.027 |
INR | 1.17 (1.07–1.37) | 1.31 (1.16–1.60) | 0.003 |
NT-proBNP (pg/mL) | 3079.15 (1471.25–6723.78) | 3930 (1310–7974) | 0.597 |
LVEF (%) | 24.20 (20.00–29.00) | 22.20 (16.00–29.50) | 0.264 |
Preoperative treatment | |||
Warfarin, n (%) | 45 (10.7) | 10 (25.0) | 0.017 |
Heparin, n (%) | 97 (23.0) | 11 (27.5) | 0.525 |
LMWH, n (%) | 108 (25.7) | 8 (20.0) | 0.431 |
Aspirin, n (%) | 77 (18.3) | 10 (25.0) | 0.300 |
Clopidogrel, n (%) | 21 (5.0) | 3 (7.5) | 0.453 |
Intubation, n (%) | 6 (1.4) | 1 (2.5) | 0.473 |
IABP, n (%) | 6 (1.4) | 2 (5.0) | 0.147 |
ECMO, n (%) | 7 (1.7) | 3 (7.5) | 0.047 |
Intraoperative data | |||
Pulmonary artery systolic pressure (mmHg) | 48.00 (34.00–61.25) | 50.00 (40.00–59.00) | 0.557 |
Cross clamp time (min) | 30.00 (26.00–36.00) | 33.00 (26.00–43.50) | 0.087 |
CPB time (min) | 106.00 (91.00–130.00) | 133.00 (103.50–154.75) | <0.001 |
Operation time (min) | 240.00 (210.00–300.00) | 300.00 (242.50–360.00) | <0.001 |
Postoperative data | |||
First 24 h of drainage (mL) | 350.00 (250.00–520.00) | 375.00 (152.50–530.00) | 0.700 |
Intubation time (min) | 2160.00 (1401.25–3254.25) | 6210.00 (2510.25–16,530.00) | <0.001 |
CRRT, n (%) | 48 (11.4) | 26 (65.0) | <0.001 |
IABP, n (%) | 161 (38.2) | 21 (52.5) | 0.078 |
ECMO, n (%) | 17 (4.0) | 9 (22.5) | <0.001 |
Nasogastric tube, n (%) | 97 (23.0) | 31 (77.5) | <0.001 |
ICU stay (hours) | 214.00 (158.50–279.50) | 424.00 (196.00–714.00) | <0.001 |
Postoperative hospital stay (days) | 34.00 (26.00–46.00) | 49.00 (29.25–72.75) | 0.001 |
In-hospital deaths | 20 (4.8) | 6 (15.0) | 0.018 |
30-day deaths | 28 (6.7) | 11 (27.5) | <0.001 |
90-day deaths | 39 (9.3) | 20 (50.0) | <0.001 |
1-year deaths | 63 (15.0) | 21 (52.5) | <0.001 |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
OR (95% CI) | p Values | OR (95% CI) | p Values | |
Age | 1.04 (1.00–1.07) | 0.027 | 1.04 (1.00–1.07) | 0.037 |
Male | 1.52 (0.73–3.17) | 0.262 | 1.11 (0.45–2.77) | 0.820 |
BMI | 0.93 (0.85–1.02) | 0.119 | ||
Cardiac operation | 1.92 (0.93–3.98) | 0.078 | ||
Gastrointestinal disease | 1.11 (0.42–2.97) | 0.835 | ||
RBC | 0.62 (0.39–0.99) | 0.046 | ||
Hb | 0.98 (0.96–0.99) | 0.003 | ||
WBC | 0.89 (0.77–1.03) | 0.128 | ||
albumin | 0.93 (0.87–1.00) | 0.050 | ||
APTT | 1.01 (0.99–1.04) | 0.244 | ||
INR | 1.24 (0.89–1.73) | 0.197 | ||
Preoperative warfarin | 2.79 (1.28–6.07) | 0.010 | 3.01 (1.07–8.48) | 0.037 |
Preoperative ECMO | 4.80 (1.19–19.32) | 0.027 | 1.741 (0.34–8.94) | 0.507 |
Cross-clamp time | 1.03 (1.00–1.06) | 0.056 | 1.00 (0.96–1.04) | 0.931 |
CPB time | 1.00 (1.00–1.01) | 0.085 | 1.00 (0.99–1.01) | 0.937 |
Operation time | 1.01 (1.00–1.01) | 0.001 | 1.00 (0.99–1.00) | 0.362 |
Postoperative CRRT | 14.43 (7.05–29.53) | <0.001 | 6.27 (2.50–15.72) | <0.001 |
Postoperative IABP | 1.79 (0.93–3.42) | 0.081 | 0.491 (0.21–1.18) | 0.112 |
Postoperative ECMO | 6.90 (2.84–16.75) | <0.001 | 2.36 (0.70–7.93) | 0.164 |
Postoperative nasogastric tube | 11.51 (5.30–25.00) | <0.001 | 5.73 (2.10–15.66) | 0.001 |
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Li, W.; Zhang, C.; Zhou, X.; Xu, Q.; Wang, K.; Lin, R.; Shi, J.; Dong, N. Clinical Outcomes and Risk Factors of Heart Transplantation Patients Experiencing Gastrointestinal Bleeding. Biomedicines 2024, 12, 1845. https://doi.org/10.3390/biomedicines12081845
Li W, Zhang C, Zhou X, Xu Q, Wang K, Lin R, Shi J, Dong N. Clinical Outcomes and Risk Factors of Heart Transplantation Patients Experiencing Gastrointestinal Bleeding. Biomedicines. 2024; 12(8):1845. https://doi.org/10.3390/biomedicines12081845
Chicago/Turabian StyleLi, Wangzi, Chiyuan Zhang, Xianming Zhou, Qian Xu, Kan Wang, Rong Lin, Jiawei Shi, and Nianguo Dong. 2024. "Clinical Outcomes and Risk Factors of Heart Transplantation Patients Experiencing Gastrointestinal Bleeding" Biomedicines 12, no. 8: 1845. https://doi.org/10.3390/biomedicines12081845