title: Neurological events after liver transplantation: a single-center experience.
abstract: The aim of this study was to identify potential risk factors linked to neurologic events (NE) occurring after liver transplantation (LT) and use them to construct a model to predict such events. From odds ratios (OR) of risk factors, a scoring system was assessed using multivariate regression analysis. Forty-one of 307 LT patients presented NE (13.3%), with prolonged hospital stay and decreased post-LT survival. On multivariate analysis, factors associated with NE included: severe pre-LT ascites OR 3.9 (1.80-8.41; P = 0.001), delta sodium ≥12 mEq/l OR 3.5 (1.36-8.67; P = 0.01), and post-LT hypomagnesemia OR 2.9 (1.37-5.98; P = 0.005). Points were assigned depending on ORs as follows: ascites 4 points, and hypomagnesemia and delta sodium ≥12 mEq/l, 3 points each (score range = 0-10 points). ROC curve analysis suggested good discriminative power for the model, with a c-statistic of 0.72 (CI 0.62-0.81; P < 0.0001), best performance for a cutoff value >3 points (71% sensitivity, 60% specificity). NE risk increased progressively from 6.4%, to 10.3%, 12.8%, 31.5% and 71.0% as scores rose from 0 to 3, 4, 6-7 and 10 cumulative points, respectively. The score described helps to identify patients potentially at risk for neurologic events, and its prevention would decrease morbidity and mortality after LT.
authors: Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Provincia de Buenos Aires, Argentina.
authors: Federico
authors: F
authors: Piñero
authors: Manuel
authors: M
authors: Mendizabal
authors: Rodolfo
authors: R
authors: Quiros
authors: Martín
authors: M
authors: Fauda
authors: Diego
authors: D
authors: Arufe
authors: Ariel
authors: A
authors: Gonzalez Campaña
authors: Mariano
authors: M
authors: Barreiro
authors: Victoria
authors: V
authors: Marquevich
authors: María P
authors: MP
authors: Raffa
authors: Sebastian
authors: S
authors: Cosenza
authors: Oscar
authors: O
authors: Andriani
authors: Luis G
authors: LG
authors: Podesta
authors: Marcelo
authors: M
authors: Silva
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003244:Consciousness Disorders / Q000453:epidemiology* / Q000209:etiology; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology; D004401:Dysarthria / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation; D008274:Magnesium / Q000097:blood; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012306:Risk; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology; D012964:Sodium / Q000097:blood; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology
chemical_list: D012964:Sodium; D008274:Magnesium
keywords: adverse events; immunosuppression; nervous system