Title
Development of a predictive model for hyperglycemia in nondiabetic recipients after liver transplantation
Date Issued
01 October 2018
Access level
open access
Resource Type
journal article
Author(s)
VanWagner L.B.
Pollack T.
Higginbotham D.
Zhao L.
Yang A.
Molitch M.E.
Wallia A.
Northwestern University
Publisher(s)
Wolters Kluwer Health
Abstract
Background. Posttransplant hyperglycemia has been associated with increased risks of transplant rejection, infections, length of stay, and mortality. Methods. To establish a predictive model to identify nondiabetic recipients at risk for developing postliver transplant (LT) hyperglycemia, we performed this secondary, retrospective data analysis of a single-center, prospective, randomized, controlled trial of glycemic control among 107 adult LT recipients in the inpatient period. Hyperglycemia was defined as a posttransplant glucose level greater than 200 mg/dL after initial discharge up to 1 month following surgery. Candidate variables with P less than 0.10 in univariate analyses were used to build a multivariable logistic regression model using forward stepwise selection. The final model chosen was based on statistical significance and additive contribution to the model based on the Bayesian Information Criteria. Results. Forty-three (40.2%) patients had at least 1 episode of hyperglycemia after transplant after the resolution of the initial postoperative hyperglycemia. Variables selected for inclusion in the model (using model optimization strategies) included length of hospital stay (odds ratio [OR], 0.83; P < 0.001), use of glucose-lowering medications at discharge (OR, 3.76; P = 0.03), donor female sex (OR, 3.18; P = 0.02) and donor white race (OR, 3.62; P = 0.01). The model had good calibration (Hosmer-Lemeshow goodness-of-fit test statistic = 9.74, P = 0.28) and discrimination (C-statistic = 0.78; 95% confidence interval, 0.65-0.81, bias-corrected C-statistic = 0.78). Conclusions. Shorter hospital stay, use of glucose-lowering medications at discharge, donor female sex and donor white race are important determinants in predicting hyperglycemia in nondiabetic recipients after hospital discharge up to 1 month after liver transplantation.
Volume
4
Issue
10
Language
English
OCDE Knowledge area
Endocrinología, Metabolismo (incluyendo diabetes, hormonas)
Gastroenterología, Hepatología
Scopus EID
2-s2.0-85064159464
Source
Transplantation Direct
ISSN of the container
23738731
Sponsor(s)
A.W. is supported by the American Diabetes Association Junior Faculty Award 1-13-JF-54. L.B.V.W. is supported by the National Institutes of Health's National
Center for Advancing Translational Sciences (KL2TR001424) and the National, Heart, Lung and Blood Institute (K23HL136891). L.Z. is supported by the National Institutes of Health grant R21AG049385.
Sources of information:
Directorio de Producción Científica
Scopus