[Article in English, Portuguese; Abstract available in Portuguese from the publisher]
Carlotto JRM1, Linhares MM1, Salzedas Netto AA1, Rangel ÉB2, Medina-Pestana JO2, Ferraro JR1, Lopes Filho GJ1, Oliva CAG3, Gonzalez A
Author information
1Universidade Federal de São Paulo, Disciplina de Gastroenterologia Cirúrgica, São Paulo, SP, Brasil.2Fundação Oswaldo Ramos, Hospital do Rim, São Paulo, SP, Brasil.3Universidade Federal de São Paulo, Disciplina de Economia e Gestão em Saúde, São Paulo, SP, Brasil.
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.