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

Objective: To provide a descriptive analysis of emergency department (ED) presentations and management of orthotopic liver transplant (OLT) patients. Methods: A retrospective chart review was performed of OLT patients presenting to the University of California at Los Angeles (UCLA) ED during 1995. The sole inclusion criterion was receiving an OLT within three years prior to the ED visit. Data describing chief complaint(s), history of present illness, physical findings, laboratory results, imaging studies, and final diagnoses were collected. Results: One hundred forty-three patients accounted for 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 which abdominal (39%), fever (17%), respiratory (13%), and neurologic (11%) symptoms were the most common. There were 478 final diagnoses, of which abdominal (27%), infectious (24%), and metabolic (11%) disorders were the most common. Eighty-four percent of ED visits resulted in extensive diagnostic testing and 69% resulted in hospitalization. Conclusions: Serious illnesses with nonspecific presentations were frequently encountered in this study population. These factors resulted in a majority of the patients' undergoing extensive diagnostic evaluations and being hospitalized.