ObjectiveTo investigate the association between preoperative systemic immune-inflammation index (SII) and early allograft dysfunction (EAD) in liver transplant recipients. MethodsThe patients underwent liver transplantation who met the inclusion and exclusion criteria in the West China Hospital of Sichuan University from January 2015 to December 2019 were collected. The postoperative EAD was analyzed. The generalized propensity score weighting (GPSW) were used to balance the confounding factors affecting the occurrence of EAD. ResultsA total of 390 patients who met the inclusion and exclusion criteria were enrolled in this study, 93 cases of EAD occurred, the incidence of EAD was 23.8%. The recipient’s model for endstage liver disease score and Child-Pugh grade, the donor’s body mass index, age, and graft weight, and the intraoperative cold ischemia time, liver transplantation time, intraoperative blood loss, total infusion, red blood cell transfusion, autologous blood reinfusion, fresh frozen plasma transfusion, concentrated platelet transfusion, total red blood cell and autologous blood transfusions were balanced by GPSW, then the overall mean correlation coefficient of the 14 covariables and SII decreased from 0.049 to 0.039, and each covariable reached the standard of less than 0.1. The binary logistic regression analysis based on GPSW showed that there was no significant association between SII and EAD (P=0.371). ConclusionFrom preliminary result of this study, it is not found that preoperative SII of liver transplantation patients is related to occurrence of postoperative EAD.
ObjectiveTo investigate the associations of preoperative red cell distribution width (RDW) with mortality and morbidity in patients underwent liver transplantation. MethodsThis investigation was a retrospective study, the patients underwent liver transplantation met the inclusion criteria from June 2017 to May 2020 in the West China Hospital of Sichuan University were enrolled. The patients were divided into RDW≤14.5% group and RDW>14.5% group according to the normal RDW critical value (14.5%). The propensity score matching (PSM) was used to adjust the baseline characteristics. The primary outcome was 1-year mortality. The secondary outcomes included 1-year survival, 30-day mortality, incidence of early allograft dysfunction, acute kidney injury, renal replacement therapy, and pulmonary complications, as well as ICU stay and postoperative hospital stay. ResultsA total of 303 patients who met the analysis conditions were included. After PSM, 57 patients in each group were matched. There were no significant differences between the two groups in the baseline data such as the gender, age, body mass index (BMI), initial diagnosis, MELD score, Child-Pugh grade of the recipients, and the gender, age, and BMI of the donors (P>0.05). The 1-year [22.8% (13/57) versus 5.3% (3/57), χ2=7.27, P=0.007] and 30-day [15.8% (9/57) versus 3.5% (2/57), χ2=4.93, P=0.026] mortality of the patients with RDW >14.5% were higher than that of the patients with RDW ≤14.5% . The Kaplan-Meier survival curve showed that the 1-year survival of the patients with RDW ≤14.5% after liver transplantation was better than that of the patients with RDW >14.5% [hazard ratio=4.75, 95%CI (1.78, 12.67), P=0.007], but there were no significant differences between the two groups in the incidence of early graft dysfunction, acute renal injury, renal replacement therapy, and pulmonary complications, as well as postoperative hospital stay and ICU stay (P>0.05). ConclusionPreliminary results of this study indicate that preoperative RDW of patients underwent allogeneic liver transplantation is associated with1-year mortality, 30-day mortality, and 1-year survival.
Focusing on research quality is a crucial aspect of modern evidence-based medical practice, providing substantial evidence to underpin clinical decision-making. The increase in real-world studies in recent years has presented challenges, with varying quality stemming from issues such as data integrity and researchers’ expertise levels. Although systematic reviews and meta-analyses are essential references for clinical decisions, their reliability is contingent upon the quality of the primary studies. Making clinical decisions based on inadequate research poses inherent risks. With the lack of a specialized tool for evaluating the quality of real-world studies within systematic reviews and meta-analyses, the Gebrye team has introduced a new assessment tool - QATSM-RWS. Comprising 5 modules and 14 items, this tool aims to improve real-world research evaluation. This article aims to elaborate on the tool’s development process and content, taking using this tool to evaluate a published real-world study as an example and providing valuable guidance for domestic researchers utilizing this innovative tool.