1. Simultaneous pancreas-kidney transplantation and the impact of postoperative complications on hospitalization cost.
- Author
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Carlotto JRM, Linhares MM, Salzedas Netto AA, Rangel ÉB, Medina-Pestana JO, Ferraro JR, Lopes Filho GJ, Oliva CAG, and Gonzalez AM
- Subjects
- Adult, Brazil, Costs and Cost Analysis, Female, Hospitalization statistics & numerical data, Humans, Kidney Transplantation economics, Male, Pancreas Transplantation economics, Pancreatectomy economics, Retrospective Studies, Young Adult, Hospitalization economics, Kidney Transplantation adverse effects, Pancreas Transplantation adverse effects, Pancreatectomy adverse effects, Postoperative Complications economics, Reoperation economics
- Abstract
Objective: considering simultaneous pancreas-kidney transplantation cases, to evaluate the financial impact of postoperative complications on hospitalization cost., Methods: a retrospective study of hospitalization data from patients consecutively submitted to simultaneous pancreas-kidney transplantation (SPKT), from January 2008 to December 2014, at Kidney Hospital/Oswaldo Ramos Foundation (Sao Paulo, Brazil). The main studied variables were reoperation, graft pancreatectomy, death, postoperative complications (surgical, infectious, clinical, and immunological ones), and hospitalization financial data for transplantation., Results: the sample was composed of 179 transplanted patients. The characteristics of donors and recipients were similar in patients with and without complications. In data analysis, 58.7% of the patients presented some postoperative complication, 21.8% required reoperation, 12.3% demanded graft pancreatectomy, and 8.4% died. The need for reoperation or graft pancreatectomy increased hospitalization cost by 53.3% and 78.57%, respectively. The presence of postoperative complications significantly increased hospitalization cost. However, the presence of death, internal hernia, acute myocardial infarction, stroke, and pancreatic graft dysfunction did not present statistical significance in hospitalization cost (in average US$ 18,516.02)., Conclusion: considering patients who underwent SPKT, postoperative complications, reoperation, and graft pancreatectomy, as well as surgical, infectious, clinical, and immunological complications, significantly increased the mean cost of hospitalization. However, death, internal hernia, acute myocardial infarction, stroke, and pancreatic graft dysfunction did not statistically interfere in hospitalization cost.
- Published
- 2019
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