[Risk Factors for Returning of Pediatric Liver Transplant Recipients to the Intensive Care Unit].

Objective To explore the risk factors for the returning of pediatric liver transplant recipients to the intensive care unit (ICU) and provide reference for the clinical decision-making after surgery. Methods A retrospective analysis was conducted with the information of all the pediatric patients who underwent liver transplantation in Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine and were returned to the ICU from 2019 to 2021.The patients returned to the ICU during hospitalization and the reasons for the return were recorded.Each patient of ICU return was matched with three pediatric patients who did not return to the ICU during hospitalization.The basic information,the vital signs and laboratory indicators on the day of transfer from ICU,immunosuppressants and drug concentrations were compared between the two groups.Multivariate Logistic regression analysis was performed to explore the risk factors for the returning of pediatric liver transplant recipients to the ICU. Results The returning rate of pediatric liver transplant recipients to the ICU was 4.36%,and it was 16.00% within 48 h.The main reasons for the return included respiratory complications,abdominal infections,and hepatic vascular occlusion.Multivariate Logistic regression analysis showed that post-operative red blood cell transfusion (OR=4.554,95%CI=1.743-11.901,P=0.002) and high serum level of uric acid (OR=1.005,95%CI=1.001-1.009,P=0.014) were the risk factors for returning to the ICU.High diastolic blood pressure (OR=0.922,95%CI=0.885-0.960,P<0.001) and high total protein level (OR=0.937,95%CI=0.891-0.986,P=0.012) were the protective factors for returning to the ICU. Conclusion Post-operative red blood cell transfusion and high serum level of uric acid are independent risk factors for the returning of pediatric liver transplant recipients to the ICU.

Validity of Chinese Version of Attitudes Toward Interprofessional Health Care Teams Scale.

OBJECTIVE: Effective teamwork can provide safe and effective care in various medical systems. Thus, there is increasing recognition of the value of interprofessional collaborative practice. The Attitudes Toward Interprofessional Health Care Teams Scale (ATIHCTS) has been applied to a wide variety of health professions for evaluating attitudes toward health care teams. The ATIHCTS has been widely used internationally, but no Chinese version has been developed. The aim of this study was to adapt a Chinese version of the ATIHCTS among Chinese health care professionals and to test its validity. METHODS: The English version of the ATIHCTS was translated into Chinese, back-translated, and modified for cultural adaptation according to Brislin's guideline. A total of 306 health professionals in a Shanghai tertiary hospital were investigated using the Chinese version of the ATIHCTS to test its validity. RESULTS: The Chinese version of the ATIHCTS was adjusted based on expert review and pilot testing. According to expert opinions, the text that did not conform to the Chinese language habits and the Chinese medical environment was adjusted. A total of five adjustments were made. After the pilot testing, minor corrections were made to improve the sentence structure of the scale instructions to make it easier to understand. Factor analysis was subsequently conducted with 306 respondents. The Chinese version of the ATIHCTS had 14 items. Exploratory factor analysis extracted two common factors, quality of care and time constraints, with the cumulative variance contribution rate reaching 70.011% and the load value of each entry on its common factor > 0.4. In addition, for scale confirmatory factor analysis (CFA), the chi-square/degrees of freedom ratio (X2/df) was 1.46, the normed fit index (NFI) was 0.97, the Tucker-Lewis index (TLI) was 0.99, the incremental fit index (IFI) was 0.99, the comparative fit index (CFI) was 0.99, and the root mean square error of approximation (RMSEA) was 0.04. The fitting values all met the judgment criteria, and the scale had good structural validity. Cronbach's α of the Chinese version of the ATIHCTS was 0.861, and the Cronbach's α values of each factor were 0.949 and 0.838, respectively. The split-half reliability was 0.644, and the Guttman split-half coefficients of each factor were 0.904 and 0.779, respectively. CONCLUSION: The Chinese version of the ATIHCTS has good validity. It is a valuable tool for evaluating attitudes toward interprofessional health care teams among the health care professionals in China.