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Abstract: Poster Presentations |

READMISSION TO AN INTENSIVE CARE UNIT AFTER LUNG TRANSPLANTATION: EXPERIENCE OF A SINGLE CENTER FREE TO VIEW

Deborah J. Levine, MD*; Luis Angel, MD; Sako Edward, MD; Stephanie Levine, MD
Author and Funding Information

University of Texas Health Science Center San Antonio, San Antonio, TX


Chest


Chest. 2005;128(4_MeetingAbstracts):340S-b-341S. doi:10.1378/chest.128.4.1951
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Abstract

PURPOSE:  Short-term survival after lung transplantation has improved such that over 90% of recipients are discharged post-operatively. Long term survival, however, can be complicated by the need for readmission to an ICU in many patients. Respiratory failure is the most common cause for re-admission, however,we found that a significant number of admissions are required for non-pulmonary issues. The purpose of this study is to evaluate the nature and frequency of icu readmissions post transplant.

METHODS:  We performed a single center review of 83 consecutive lung transplant recipients who were successfully discharged post transplant between 1/1999 and 4/2004. Evaluation included patient demographics, pretransplant diagnoses, and time and diagnoses of admission to University Hospital’s ICU up until 7/2004. Patient charts and ICD-9 codes were used to document distribution of the primary diagnoses. Demographics were compared to patients who did not require readmission during the study period.

RESULTS:  A total of 83 single (21%)and bilateral (79%)lung transplants were performed at our institution from 1/99 to 5/2004. 28 patients(34%) required re-admission to University Hospital’s ICU 49 times until 7/2004. Demographics including age, type of transplant, sex, and pre-transplant diagnosis were not significantly different from those not requiring re-admission. Distribution of primary readmission diagnoses are outlined in Table 1. Pulmonary dysfunction was the major complication leading to ICU admission (59%). 41% of admissions were distributed between non-pulmonary complications. Time to readmission ranged from 27 days to 540 days with a mean of 200 days.

CONCLUSION:  Respiratory failure was the most common reason for readmission to our ICU post lung transplantation. However, there was a distinct subset of characteristic non-pulmonary issues that occurred with enough frequency (41%), that they warrant further evaluation.

CLINICAL IMPLICATIONS:  Further study is needed to identify which clinical factors (pre-transplant co-morbidities,immunosuppression,etc), either pre- or post transplantation, may predict a return to the ICU after initial discharge following transplantation. Table 1

Primary Diagnoses for Lung Transplant Recipients Readmitted to the ICU

CausePercentPulmonary59% (pneumonia, rejection, pleural effusion, pulmonary embolus)Cardiac10%Hematologic/Oncologic8%Neurologic8%Infectious Disease (not including pneumonia)6%Renal6%Endocrine2%

DISCLOSURE:  Deborah Levine, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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