Table 5. Patient and Procedural Risk Factors for a Non-Diagnostic EMB Sample in Heart Transplant Recipients.
N (%) is provided for categorical variables, median [interquartile range] is provided for ordinal/continuous variables, and mean ± s.d. is provided for normally distributed continuous variables. Odds ratio expresses risk of obtaining a non-diagnostic sample calculated using generalized estimating equations (GEE) models.
| Demographic / Clinical Predictors | EMB Sample | Univariate Analysis | ||
|---|---|---|---|---|
| Non-Diagnostic Sample (n=15) | Diagnostic Sample (n=1123) | Odds Ratio | P value | |
| Age | ||||
| < 1 year | 0 (0) | 40 (4) | — | — |
| 1-9 years | 0 (0) | 386 (34) | — | — |
| ≥ 10 years | 15 (100) | 697 (62) | — | — |
| Weight | ||||
| < 10 kg | 0 (0) | 86 (8) | — | — |
| ≥ 10 kg | 15 (100) | 1037 (92) | — | — |
| Time since heart transplant (years); OR for each additional year since transplant | 8.6 [3.3, 10.6] | 1.6 [0.4, 4.5] | 1.2 (1.1, 1.2) | <0.001 |
| Admission Status | ||||
| Elective | 14 (93) | 1082 (96) | 1.0 | — |
| Urgent or Emergent | 1 (7) | 41 (4) | 1.9 (0.2, 14.2) | 0.54 |
| Airway & Sedation Management | ||||
| Spontaneous respiration | 11 (73) | 544 (48) | 1.0 | — |
| Other mechanical support with anesthesia | 4 (27) | 579 (52) | 0.3 (0.1, 1.1) | 0.08 |
| Hemodynamic Parameters | ||||
| Cardiac index (L/min/m2); OR for each 1 L/min/m2 decrease in CI | 3.0 ± 0.7 | 3.6 ± 1.1 | 2.2 (1.1, 4.3) | 0.02 |
| Access (n=13, 1095) | ||||
| Right or left femoral vein | 4 (31) | 471 (43) | 1.0 | — |
| Right or left internal jugular vein | 8 (61) | 586 (54) | 1.6 (0.5, 5.7) | 0.46 |
| Right or left subclavian vein | 1 (8) | 38 (3) | 3.1 (0.3, 29.8) | 0.33 |
| Case performed by | ||||
| Attending | 6 (40) | 752 (67) | 1.0 | — |
| Attending and fellow | 1 (7) | 67 (6) | 1.9 (0.2, 16.6) | 0.57 |
| Fellow | 8 (53) | 304 (27) | 3.3 (1.0, 10.5) | 0.04 |
| Type of bioptome | ||||
| Sparrow Hawk | 11 (73) | 312 (28) | 7.1 (1.9, 27.3) | 0.004 |
| Other | 4 (27) | 811 (72) | 1.0 | — |
| Size of bioptome | ||||
| 3, 4, or 5 Fr | 10 (67) | 398 (36) | 3.6 (1.1, 12.2) | 0.04 |
| 6 or 7 Fr | 5 (33) | 723 (64) | 1.0 | — |
| Number of biopsy attempts; OR for each additional attempt | 7 [6, 9] | 5 [4, 6] | 1.3 (1.2, 1.5) | <0.001 |
| Number of pieces obtained | 6 [5, 6] | 5 [4, 5] | 1.0 (1.0, 1.1) | 0.07 |
| Center performing the Biopsy | ||||
| Center B | 10 (67) | 193 (17) | 9.6 (2.9, 32.5) | <0.001 |
| All others | 5 (33) | 930 (83) | 1.0 | — |
EMB, Endomyocardial biopsy; CI, Cardiac Index; Fr, French;