Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/23500
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dc.contributor.authorKoshy, Anoop N-
dc.contributor.authorKo, Jefferson-
dc.contributor.authorFarouque, Omar-
dc.contributor.authorCooray, Shamil D-
dc.contributor.authorHan, Hui-Chen-
dc.contributor.authorCailes, Benjamin-
dc.contributor.authorGow, Paul J-
dc.contributor.authorWeinberg, Laurence-
dc.contributor.authorTestro, Adam G-
dc.contributor.authorLim, Han S-
dc.contributor.authorTeh, Andrew W-
dc.date2020-06-12-
dc.date.accessioned2020-06-15T06:54:46Z-
dc.date.available2020-06-15T06:54:46Z-
dc.date.issued2021-02-
dc.identifier.citationAmerican Journal of Transplantation 2021; 21(2): 593-603en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/23500-
dc.description.abstractLiver transplantation(LT) has a four-fold higher risk of periprocedural cardiac arrest and ventricular arrhythmias(CA/VA) compared with other noncardiac surgeries. Prolongation of the corrected QT interval(QTc) is common in patients with liver cirrhosis. Whether it is associated with an increased risk of CA/VA following LT is unclear. Rates of 30-day CA/VA post-LT was assessed in consecutive adults undergoing LT between 2010-2017. Pre-transplant QTc was measured by a cardiologist blinded to clinical outcomes. Among 408 patients included, CA/VA occurred in 26(6.4%) patients. QTc was significantly longer in CA/VA patients(475±34 vs 450±34 milliseconds, p<0.001). Optimal QTc cut-off for prediction of CA/VA was ≥480ms. After adjustment, QTc≥480ms remained the strongest predictor for the occurrence of CA/VA(Odds ratio[OR] 5.2 95%CI 2.2-12.6). A point-based cardiac arrest risk index(CARI) was derived with the bootstrap method for yielding optimism-corrected coefficients(2-points:QTc ≥480, 1-point:MELD≥30, 1-point:age≥65 and 1-point:male). CARI score≥3 demonstrated moderate discrimination(c-statistic 0.79, optimism-corrected c-statistic 0.77) with appropriate calibration. Conclusion: QTc≥480ms was associated with a five-fold increase in the risk of CA/VA. The CARI score may identify patients at higher risk of these events. Whether heightened perioperative cardiac surveillance, avoidance of QT prolonging medications or beta-blockers could mitigate the risk of CA/VA in this population merits further study.en_US
dc.language.isoeng-
dc.titleEffect of QT Interval Prolongation on Cardiac Arrest following Liver Transplantation and Derivation of a Risk Index.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAmerican Journal of Transplantationen_US
dc.identifier.affiliationAnaesthesiaen_US
dc.identifier.affiliationThe University of Melbourne, Parkville, Victoria, Australiaen_US
dc.identifier.affiliationVictorian Liver Transplant Uniten_US
dc.identifier.affiliationCardiologyen_US
dc.identifier.affiliationMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australiaen_US
dc.identifier.doi10.1111/ajt.16145en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0001-6505-7233en_US
dc.identifier.orcid0000-0002-8741-8631en_US
dc.identifier.orcid0000-0001-7403-7680en_US
dc.identifier.pubmedid32530547-
dc.type.austinJournal Article-
local.name.researcherCailes, Benjamin
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptAnaesthesia-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
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