Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation

Abstract Profound hypotension during liver transplantation is aggressively treated with vasopressors thus frequently unrevealed in a retrospective study. The relationship between concealed intraoperative hypotension and in-hospital mortality after liver transplantation was evaluated using performanc...

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Autores principales:	Hyung-Chul Lee, Ho-Geol Ryu, Chul-Woo Jung
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c1c91f89b8b04496b637882775a595a4
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spelling	oai:doaj.org-article:c1c91f89b8b04496b637882775a595a42021-12-02T15:05:06ZPerformance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation10.1038/s41598-017-07664-02045-2322https://doaj.org/article/c1c91f89b8b04496b637882775a595a42017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-07664-0https://doaj.org/toc/2045-2322Abstract Profound hypotension during liver transplantation is aggressively treated with vasopressors thus frequently unrevealed in a retrospective study. The relationship between concealed intraoperative hypotension and in-hospital mortality after liver transplantation was evaluated using performance measurement (PM) of systolic arterial pressure (SAP). Median performance error (MDPE), median absolute performance error (MDAPE), and wobble of SAP were calculated using preoperative SAP as the reference value, and prereperfusion and postreperfusion SAPs as measured values. Univariable and multivariable logistic regression analyses were performed using 6 PM parameters and 36 traditional SAP-derived parameters to predict in-hospital mortality. In-hospital mortality was 3.9% (22/569 cases). Prereperfusion MDAPE and postreperfusion wobble were the only significant SAP-derived predictors of in-hospital mortality. The area under receiver operating characteristic curve of prediction model was 0.769 (95% confidence interval 0.732–0.803, P < 0.001; sensitivity = 55%, specificity = 94%). Severe hypotension during liver transplantation is concealed by proactive vasopressor treatment thus traditional measures of hypotension generally fail to detect the masked hypotension in retrospective analysis. PM analysis of intraoperative SAP including prereperfusion MDAPE and postreperfusion wobble is most likely to detect treated and therefore concealed hypotension, and was able to independently and quantitatively predict in-hospital mortality after liver transplantation with high diagnostic specificity.Hyung-Chul LeeHo-Geol RyuChul-Woo JungNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyung-Chul Lee Ho-Geol Ryu Chul-Woo Jung Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
description	Abstract Profound hypotension during liver transplantation is aggressively treated with vasopressors thus frequently unrevealed in a retrospective study. The relationship between concealed intraoperative hypotension and in-hospital mortality after liver transplantation was evaluated using performance measurement (PM) of systolic arterial pressure (SAP). Median performance error (MDPE), median absolute performance error (MDAPE), and wobble of SAP were calculated using preoperative SAP as the reference value, and prereperfusion and postreperfusion SAPs as measured values. Univariable and multivariable logistic regression analyses were performed using 6 PM parameters and 36 traditional SAP-derived parameters to predict in-hospital mortality. In-hospital mortality was 3.9% (22/569 cases). Prereperfusion MDAPE and postreperfusion wobble were the only significant SAP-derived predictors of in-hospital mortality. The area under receiver operating characteristic curve of prediction model was 0.769 (95% confidence interval 0.732–0.803, P < 0.001; sensitivity = 55%, specificity = 94%). Severe hypotension during liver transplantation is concealed by proactive vasopressor treatment thus traditional measures of hypotension generally fail to detect the masked hypotension in retrospective analysis. PM analysis of intraoperative SAP including prereperfusion MDAPE and postreperfusion wobble is most likely to detect treated and therefore concealed hypotension, and was able to independently and quantitatively predict in-hospital mortality after liver transplantation with high diagnostic specificity.
format	article
author	Hyung-Chul Lee Ho-Geol Ryu Chul-Woo Jung
author_facet	Hyung-Chul Lee Ho-Geol Ryu Chul-Woo Jung
author_sort	Hyung-Chul Lee
title	Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
title_short	Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
title_full	Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
title_fullStr	Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
title_full_unstemmed	Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
title_sort	performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/c1c91f89b8b04496b637882775a595a4
work_keys_str_mv	AT hyungchullee performancemeasurementofintraoperativesystolicarterialpressuretopredictinhospitalmortalityinadultlivertransplantation AT hogeolryu performancemeasurementofintraoperativesystolicarterialpressuretopredictinhospitalmortalityinadultlivertransplantation AT chulwoojung performancemeasurementofintraoperativesystolicarterialpressuretopredictinhospitalmortalityinadultlivertransplantation
_version_	1718388980251099136

Performance measurement of intraoperative systolic arterial pressure to predict in-hospital mortality in adult liver transplantation

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