Early Allograft Dysfunction Is Associated With Excess Resource Utilization After Liver Transplantation

Abstract Background There are limited data on length of stay (LOS) following liver transplantation (LT), yet this is an important health services metric that directly correlates with early post-LT health care costs. The primary objective of this study was to examine the relationship between early al...

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Bibliographic Details
Published in:Transplantation proceedings 2013, Vol.45 (1), p.259-264
Main Authors: Croome, K.P, Hernandez-Alejandro, R, Chandok, N
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Graft Survival
Hospitalization
Humans
Length of Stay - economics
Liver Failure - economics
Liver Failure - surgery
Liver Transplantation - economics
Liver Transplantation - methods
Male
Middle Aged
Ontario
Postoperative Complications - economics
Prospective Studies
Quality Assurance, Health Care
Regression Analysis
Severity of Illness Index
Surgery
Time Factors
Tissue Donors
Transplantation, Homologous - economics
Treatment Outcome
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Summary:Abstract Background There are limited data on length of stay (LOS) following liver transplantation (LT), yet this is an important health services metric that directly correlates with early post-LT health care costs. The primary objective of this study was to examine the relationship between early allograft dysfunction (EAD) and LOS after LT. The secondary objective was to identify additional recipient, donor, and operative factors associated with LOS. Methods Adult patients undergoing primary LT over a 32-month period were prospectively examined at a single center. Subjects fulfilling standard criteria for EAD were compared with those not meeting the definition. Variables associated with increased LOS on ordinal logistic regression were identified. Results Subjects with EAD had longer mean hospital LOS than those without (42.5 ± 38.9 days vs 27.4 ± 31 days; P = .003). Subjects with EAD also had longer mean intensive care LOS (8.61 ± 10.28 days vs 5.45 ± 11.6 days; P = .048). Additional factors significantly associated with LOS included Model for End-Stage Liver Disease (MELD) score, recipient location before LT, and postoperative surgical complications. Conclusions EAD is associated with longer hospitalization after LT. MELD score, preoperative recipient location, and postoperative complications were significantly associated with LOS. From a cost-containment perspective, these findings have implications on resource allocation.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.07.147