Journal of Clinical Pediatrics ›› 2023, Vol. 41 ›› Issue (2): 134-139.doi: 10.12372/jcp.2023.22e0452

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Risk factors of 90-day readmission after liver transplantation in children with biliary atresia

WAN Shuangshuang1, XU Renying2, QIAN Yongbing3, HONG Li4, FENG Yi1,5()   

  1. 1. Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
    2. Department of Clinical Nutrition, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3. Department of Liver Transplantation, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    4. Department of Clinical Nutrition, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    5. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
  • Received:2022-04-18 Online:2023-02-15 Published:2023-02-16

Abstract:

Objective To investigate the 90-day readmission rate and risk factors of children with biliary atresia (BA) after liver transplantation (LT). Methods This retrospective cohort study was conducted in Xinhua Hospital, Renji Hospital and Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine from January 1 to December 31, 2019. Data of children with BA who received LT for the first time were retrospectively analyzed. Patients were divided into readmission group and non-readmission group according to whether they were readmitted within 90 days after LT. The differences between the two groups were compared. Logistic regression was used to analyze the risk factors of 90-day readmission. Results A total of 264 children (female 53.0%) were included, with a median age of 6.9 (5.6-9.4) months. The 90-day readmission rate was 22.0% (58 / 264). Compared with the non-readmission group, the readmission group had higher pediatric end-stage liver disease (PELD) score, higher serum total bile acid level (TBA), higher international normalized ratio (INR), longer length of hospital stays (LOS), lower platelet count and lower psoas muscle area (PMA), and all the difference were statistically significant (P<0.05). Binary logistic regression analysis showed that thrombocytopenia (OR =2.347, 95%CI: 1.154-4.776), TBA (OR =1.058, 95% CI: 1.011-1.106), PMA (OR = 0.615, 95% CI: 0.301-0.989), and LOS (OR= 1.069, 95% CI: 1.031-1.109) were the influencing factors of 90-day readmission after pediatric LT, with statistical significance (P<0.05).Conclusions Children with thrombocytopenia, elevated TBA, lower PMA and long LOS had a higher risk of 90-day readmission after LT.

Key words: readmission, biliary atresia, liver transplantation