[Mortality analysis of patients undergoing lung transplantation for emphysema].
BACKGROUND
The outcomes of lung transplantation 11 years after starting the transplantation program in our hospital are presented. Risk factors associated with short-, medium-, and long-term mortality in transplant recipients were analyzed.


METHODS
All patients diagnosed with emphysema who underwent lung transplantation between March 1997 and June 2008 were included. The association between different study variables and early death and death at 1 year and 5 years was studied. The Kaplan-Meier method was used to analyze survival. A logistic regression model was used to study the association between early death and variables with a trend towards significance (P<.2) in the univariate analysis. The risk factors for mortality at 1 year and 5 years were analyzed by a Cox regression model.


RESULTS
A total of 92 patients were included. Survival was 89.3%, 70%, and 54% at 1 month, 1 year, and 5 years after transplantation, respectively. Dehiscence of the surgical suture (P<.001), duration of mechanical ventilation in the intensive care unit (P=.04), duration of the surgical procedure (P<.001), and single-lung transplantation (P=.007) were the variables associated with mortality. Extracorporeal circulation and the need for hemodiafiltration in the intensive care unit increased the short-term risk of death (P<.05). The age of the recipient was the variable associated with long-term mortality (P=.02). The duration of the surgical intervention was associated with an increase in short-, medium-, and long-term mortality.


CONCLUSIONS
Complications were responsible for short-term mortality, while age of the recipient was the most important factor in determining long-term survival. Mortality was higher in single-lung transplant recipients compared to double-lung transplant recipients.
Miñambres
Eduardo
E
Servicio de Medicina Intensiva, Unidad de Trasplante Pulmonar, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. eminambres@yahoo.es
Zurbano
Felipe
F
Naranjo
Sara
S
Llorca
Javier
J
Cifrián
José Manuel
JM
González-Castro
Alejandro
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D004646:Emphysema / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017583:Hemodiafiltration / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D016040:Lung Transplantation / Q000401:mortality* / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D016016:Proportional Hazards Models; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013529:Surgical Wound Dehiscence / Q000401:mortality; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications