Impacto das complicações pós-transplante simultâneo pâncreas-rim sobre o custo da internação hospitalar.

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. CarlottoSimultaneous pancreas-kidney transplantation and the impact of postoperative complications on hospitalization cost.

Application of a specialist nurse-led multidisciplinary team model in the perioperative care of patients undergoing simultaneous pancreas and kidney transplantation: randomized controlled trial

“…According to a study conducted outside of China ( 12 ), the hospitalization costs ranged from $75,200 to $87,800 and the laboratory testing costs were $23,600–$11,200 for patients undergoing SPKT, and the above expenditures did not include the organ acquisition costs. The high hospitalization expenses pose a huge financial challenge to SPKT patients ( 13 ). In addition, bleeding, thrombosis, and infections after SPKT are the main causes of prolonged hospitalization, and the incidence of readmission reached 74.2% in SPKT patients due to various infections ( 14 ).…”

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

“…The main causes of prolonged hospital stay and high hospitalization costs for acute-care hospital patients are related to development of complications, such as an infectious disease 1 . It has also been shown that prolonged hospitalization of general internal medicine inpatients is associated with higher costs and complication rates because of nosocomial infections 2 , and that postoperative complications such as infection increased the cost of hospitalization for patients who underwent a simultaneous pancreas-kidney transplantation 3 . Additionally, a strong relationship among hospitalization costs, healthcare resource utilization, and postoperative complications following a lower anterior resection procedure for rectal cancer has been demonstrated 4 .…”