Prolonged Hospital Stay Predicts Worse Outcomes After Pancreas Transplantation: An Analysis of the SRTR Database.

Abstract

Objectives: Postoperative length of hospital stay is a crucial predictor of short-term outcomes, yet few studies have explored the effects of length of hospitalization on prognosis following pancreas transplant.

Materials and methods: We analyzed data from the Scientific Registry of Transplant Recipients (January 2000-December 2014) for first-time pancreas transplant recipients. Patients were categorized into normal (<20 days) and prolonged (≥20 days) length of hospital stay groups. The relationship between length of stay and graft and patient survival was examined.

Results: Our study included 15047 first-time pancreas transplant patients, with 1465 having prolonged length of stay and 13582 having normal length of stay. Graft and patient survival rates were significantly lower in the prolonged compared with the normal length of stay group (P < .001). Patient survival rates at 1, 3, and 5 years were 91.8%, 85.5%, and 78.5% in the prolonged and 97.7%, 94.3%, and 89.6% in the normal length of stay groups, respectively. Graft survival rates at 1, 3, and 5 years were 80.7%, 74.4%, and 69.5% in the prolonged and 93.4%, 87.4%, and 82.6% in the normal length of stay groups, respectively. Prolonged length of stay was a risk factor for 1-year graft survival (hazard ratio = 2.301; 95% CI, 1.920-2.757). Longer lengths of hospital stay were significantly associated with poorer survival (P < .001).

Conclusions: Prolonged length of hospital stay was significantly related to reduced graft and patient survival rates after pancreas transplant. Optimizing factors that may lead to prolonged length of stay and providing targeted adjuvant therapy can potentially mitigate associated adverse effects and reduce postoperative expenses.