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Does phrenic nerve injury in lung transplantation increase mortality and morbidity? A retrospective analysis in a large transplant centre
e75
Abstracts
Does phrenic nerve injury in lung transplantation increase mortality and morbidity? A retrospective analysis in a large transplant centre Victor Aguirre, MBBS *, Franklin Rosenfeldt, MD FRACS, Silvana Marasco, MS FRACS, Glen Westall, PhD FRACP, Jim Duncan, RN, Adam Zimmet, MD FRACS
PNI was associated with a significantly higher mortality (hazard ratio 2.2) and longer stay in ICU and in hospital (Table). Eight predictors of PNI were tested but only surgical time reached even borderline significance (6.3hrs0.4 vs 5.6 0.1 hrs; p=0.059), suggesting that technical factors in complex surgical cases may contribute to PNI.
The Alfred Hospital, Melbourne, Australia * Corresponding author.
Outcome
PNI (N=22)
No PNI (N=297)
Introduction: Phrenic nerve injury (PNI) is an infrequent complication of lung transplantation but the incidence and consequences are not well described. The aim of this study was analyse the outcomes and identify predictors of PNI. Methods: We conducted a retrospective review of patients undergoing single or double lung transplantation between January 2008 and April 2013 in a major transplant unit. PNI was diagnosed by a positive functional study, either by fluoroscopy or ultrasound. Clinical outcomes included mortality, length of ICU stay and length of hospital stay. Outcomes were analysed using univariate and multivariate statistics adjusting for age, gender, diabetes and smoking history. Eight different demographic and surgical characteristics were tested as possible predictors of PNI. Results: A total of 319 transplants were included, 29 single and 290 double. The incidence of PNI was 6.9% (22 patients).
Mortality at
40.9%
24.9%
35.7W17.5
(N=9)
(N=74)
Univariate Multivariate
0.04
0.03
0.01
0.02
<0.01
<0.01
(months) Hospital stay 8.2 (days) (2.7-20.6) ICU stay (days)
38.2
5.4 (3.2-7.8) 21.7
(24.6-65.8) (17.6-30.6)
Conclusions: Phrenic nerve injury following lung transplantation is a major complication associated with increased mortality and morbidity. Further studies should address preventative actions during surgery and also post-operative management steps to reduce adverse outcomes. http://dx.doi.org/10.1016/j.hlc.2014.12.157
Abstracts
Does phrenic nerve injury in lung transplantation increase mortality and morbidity? A retrospective analysis in a large transplant centre Victor Aguirre, MBBS *, Franklin Rosenfeldt, MD FRACS, Silvana Marasco, MS FRACS, Glen Westall, PhD FRACP, Jim Duncan, RN, Adam Zimmet, MD FRACS
PNI was associated with a significantly higher mortality (hazard ratio 2.2) and longer stay in ICU and in hospital (Table). Eight predictors of PNI were tested but only surgical time reached even borderline significance (6.3hrs0.4 vs 5.6 0.1 hrs; p=0.059), suggesting that technical factors in complex surgical cases may contribute to PNI.
The Alfred Hospital, Melbourne, Australia * Corresponding author.
Outcome
PNI (N=22)
No PNI (N=297)
Introduction: Phrenic nerve injury (PNI) is an infrequent complication of lung transplantation but the incidence and consequences are not well described. The aim of this study was analyse the outcomes and identify predictors of PNI. Methods: We conducted a retrospective review of patients undergoing single or double lung transplantation between January 2008 and April 2013 in a major transplant unit. PNI was diagnosed by a positive functional study, either by fluoroscopy or ultrasound. Clinical outcomes included mortality, length of ICU stay and length of hospital stay. Outcomes were analysed using univariate and multivariate statistics adjusting for age, gender, diabetes and smoking history. Eight different demographic and surgical characteristics were tested as possible predictors of PNI. Results: A total of 319 transplants were included, 29 single and 290 double. The incidence of PNI was 6.9% (22 patients).
Mortality at
40.9%
24.9%
35.7W17.5
(N=9)
(N=74)
Univariate Multivariate
0.04
0.03
0.01
0.02
<0.01
<0.01
(months) Hospital stay 8.2 (days) (2.7-20.6) ICU stay (days)
38.2
5.4 (3.2-7.8) 21.7
(24.6-65.8) (17.6-30.6)
Conclusions: Phrenic nerve injury following lung transplantation is a major complication associated with increased mortality and morbidity. Further studies should address preventative actions during surgery and also post-operative management steps to reduce adverse outcomes. http://dx.doi.org/10.1016/j.hlc.2014.12.157