Nathan P Goodrich1, Douglas E Schaubel, Abigail R Smith, Robert M Merion, Pratima Sharma. 1. 1 Arbor Research Collaborative for Research, Ann Arbor, MI. 2 Department of Biostatistics, University of Michigan, Ann Arbor, MI. 3 Department of Surgery, University of Michigan, Ann Arbor, MI. 4 Division of Gastroenterology, University of Michigan, Ann Arbor, MI.
Abstract
BACKGROUND: We examined the association of incident end-stage renal disease (ESRD) after liver transplantation (LT) and resource utilization using a data linkage between the Scientific Registry of Transplant Recipients and claims data from the Centers for Medicare and Medicaid Services. METHODS: The study cohort consisted of patients aged ≥18 years who underwent deceased donor LT between January 1, 2003, and December 31, 2010, with Medicare as primary or secondary insurance and were discharged alive from the index LT hospitalization (n = 7019). The association of ESRD and post-LT hospitalization was assessed by sequential stratification, which entailed prognostic score matching of ESRD-free patients to each LT recipient at ESRD onset. The prognostic score was developed from a model of time to hospitalization and included baseline factors and hospitalization history as predictors. RESULTS: The overall hospitalization rates for LT recipients with and without ESRD were 2.7 and 1.1 per patient-year at risk, respectively. The total number of days hospitalized patient per year was 23 in ESRD and 7 in non-ESRD LT recipients. The adjusted post-LT hospitalization rate was 97% higher after reaching ESRD compared to non-ESRD (hazard ratio, 1.97; P < 0.0001). CONCLUSIONS: Hospitalization rates increased significantly for LT recipients after ESRD onset. Early risk factor modification efforts targeting patients who are at high ESRD risk may reduce post-LT ESRD incidence and hence decrease morbidity and cost among LT recipients.
BACKGROUND: We examined the association of incident end-stage renal disease (ESRD) after liver transplantation (LT) and resource utilization using a data linkage between the Scientific Registry of Transplant Recipients and claims data from the Centers for Medicare and Medicaid Services. METHODS: The study cohort consisted of patients aged ≥18 years who underwent deceased donor LT between January 1, 2003, and December 31, 2010, with Medicare as primary or secondary insurance and were discharged alive from the index LT hospitalization (n = 7019). The association of ESRD and post-LT hospitalization was assessed by sequential stratification, which entailed prognostic score matching of ESRD-freepatients to each LT recipient at ESRD onset. The prognostic score was developed from a model of time to hospitalization and included baseline factors and hospitalization history as predictors. RESULTS: The overall hospitalization rates for LT recipients with and without ESRD were 2.7 and 1.1 per patient-year at risk, respectively. The total number of days hospitalized patient per year was 23 in ESRD and 7 in non-ESRD LT recipients. The adjusted post-LT hospitalization rate was 97% higher after reaching ESRD compared to non-ESRD (hazard ratio, 1.97; P < 0.0001). CONCLUSIONS: Hospitalization rates increased significantly for LT recipients after ESRD onset. Early risk factor modification efforts targeting patients who are at high ESRD risk may reduce post-LT ESRD incidence and hence decrease morbidity and cost among LT recipients.
Authors: Pratima Sharma; Nathan P Goodrich; Douglas E Schaubel; Mary K Guidinger; Robert M Merion Journal: J Am Soc Nephrol Date: 2013-09-12 Impact factor: 10.121
Authors: Martin S Zand; Mark S Orloff; Peter Abt; Siddharth Patel; George Tsoulfas; Randeep Kashyap; Ashok Jain; Saman Safadjou; Adel Bozorgzadeh Journal: Clin Transplant Date: 2011 Mar-Apr Impact factor: 2.863
Authors: R Ruebner; D Goldberg; P L Abt; R Bahirwani; M Levine; D Sawinski; R D Bloom; P P Reese Journal: Am J Transplant Date: 2012-07-03 Impact factor: 8.086
Authors: Pratima Sharma; Nathan P Goodrich; Douglas E Schaubel; Abigail R Smith; Robert M Merion Journal: Liver Transpl Date: 2017-09 Impact factor: 5.799