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Kidney Week

Abstract: FR-PO1155

Delayed Graft Function (DGF) in Kidney Transplantation Patients: An Analysis of Disease Burden

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Mayne, Tracy J., Angion BioMedica, San Francisco, California, United States
  • Corvino, Frank A., Genesis Research, Hoboken, New Jersey, United States
  • Dillon, Allison L., Genesis Research, Hoboken, New Jersey, United States
  • Wang, Weiying, Genesis Research, Hoboken, New Jersey, United States
  • Mohan, Sumit, Columbia University, New York, New York, United States
Background

Kidney transplantation patients with DGF are at greater risk of graft failure and mortality, as well as additional disease burden. Hospitals are sensitive to both short- and medium-term costs as they are reimbursed through a 90-day Diagnosis Related Group (DRG) code and must manage all related expenses within the bundled payment. This study aims to assess patient characteristics, Health Resource Use (HRU) and costs associated in post-transplant patients with and without DGF in the hospital setting.

Methods

A retrospective analysis of the Premier Hospital Database (PHD) was performed on adult kidney transplant patients from January 2014 to December 2018. Kidney transplant patients were identified via ICD9/10 procedure codes and charge codes. DGF status was defined as the presence of a dialysis charge code within 7 days following a transplant. Patient and admission characteristics, HRU and costs were calculated for patients with and without DGF.

Results

Of the 12,097 kidney transplant patients, 3,087 (25.5%) had DGF. The majority of transplants (79.2%) were performed at large 500+ bed facilities and in urban areas (95.5%); males represented 61.1% of all transplant patients with a slightly higher proportion (64.2%) in the DGF group. The primary insurer (67.9%) of all patients was Medicare. Black patients (36.5%) had a higher incidence DGF compared to other races. DGF patients were also older (median 55 vs 53 years). The incidence proportion of DGF increased from 22.6% to 26.7% from 2014 to 2018. Patients with DGF had longer mean and median hospital stays of 11.5 and 8 days, compared to 7.3 and 6 days (p<0.01) in non-DGF patients. A significantly higher proportion of DGF patients (59.1% vs 56.0%, p<0.01) were admitted to the ICU and had a longer length of stay (mean days: 4.8 vs 2.5, p<0.01. The mean total admission costs for the Medicare patients were higher in DGF patients ($113,628.9 vs $105,962.4, p<0.01). The same trend was observed for ICU costs during admission ($5,815.0 vs $3,901.4, p<0.01).

Conclusion

DGF leads to longer hospital stay, significantly higher admission costs and a higher percentage of patients being admitted to the ICU compared to patients without DGF.

Funding

  • Commercial Support