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

• Ano de defesa: 2018
• Autor(a) principal: Carlotto, Jorge Roberto Marcante [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Transplantation; Pancreas transplantation; Economics medical; Costs and cost analysis; Transplante; Transplante de pâncreas; Complicações pós-operatórias; Economia médica; Custos e análise de custo
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6446881; https://repositorio.unifesp.br/handle/11600/52440

Objective: To evaluate the financial impact of postoperative complications in the simultaneous pancreaskidney transplantation during hospitalization. Methods: In the study, were retrospectively analyzed the clinical and financial data of the hospitalization of patients submitted consecutively to the simultaneous pancreaskidney transplantation from January 2008 to December 2014 at Hospital Rim/Fundação Oswaldo Ramos. The main variables studied were reoperation, graft pancreatectomy, death, postoperative complications (surgical, infectious, clinical and immunological) and the financial data of hospitalization for transplantation. Results: The sample consisted of 179 transplants. In the analysis of the data, 58.7% of the patients had some postoperative complications and 21.8% required reoperation, 12.3% of graft pancreatectomy and 8.4% evolved to death. The characteristics of donors and recipients were similar in patients with and without complications. The average real cost of hospitalization was US$ 18,516.02. The need for reoperation or graft pancreatectomy increased hospitalization costs by 53,30% and 78,57%, respectively (p<0,001). The presence of postoperative complication or the severity of the complication significantly increased the cost (p<0,05). However, the presence of death, internal hernia, acute myocardial infarction, stroke and pancreatic graft dysfunction were not statistically significant in the final cost (p>0,05). Conclusions: In the sample studied, we observed that the presence of postoperative complications, reoperation and graft pancreatectomy increased the cost of simultaneous pancreaskidney transplantation. However, postoperative death, internal hernia, acute myocardial infarction, stroke, and pancreatic graft dysfunction do not interfere with this cost.