A descriptive analysis of 290 liver transplant patient visits to an emergency department

Objective: To provide a descriptive analysis of emergency department (ED) p resentations and management of orthotopic liver transplant (OLT) patients. Methods: A retrospective chart review was performed of OLT patients present ing to the University of California at Los Angeles (UCLA) ED during 1995. T he sole inclusion criterion was receiving an OLT within three years prior t o the ED visit. Data describing chief complaint(s), history of present illn ess, physical findings, laboratory results, imaging studies, and final diag noses were collected. Results: One hundred forty-three patients accounted f or a total of 290 ED visits. The patients had a mean age of 37 years (range 3 months to 74 years) and presented at mean post-OLT duration of 9 months (range 2 weeks to 34 months). There were 660 presenting complaints, of whic h abdominal (39%), fever (17%), respiratory (13%), and neurologic (11%) sym ptoms were the most common. There were 478 final diagnoses, of which abdomi nal (27%), infectious (24%), and metabolic (11%) disorders were the most co mmon. Eighty-four percent of ED visits resulted in extensive diagnostic tes ting and 69% resulted in hospitalization. Conclusions: Serious illnesses wi th nonspecific presentations were frequently encountered in this study popu lation. These factors resulted in a majority of the patients' undergoing ex tensive diagnostic evaluations and being hospitalized.