Spoorthi Kamepalli, Cameron Goff, Liam Ferreira, Ashley Montgomery, Anna Lang, George Cholankeril, Abbas Rana
{"title":"A Three Decade Analysis of Trends in Length of Stay After Liver Transplantation.","authors":"Spoorthi Kamepalli, Cameron Goff, Liam Ferreira, Ashley Montgomery, Anna Lang, George Cholankeril, Abbas Rana","doi":"10.1177/15269248251327428","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionWhile survival following liver transplantation has improved over the past 3 decades, few studies have examined the changes over time in hospital length of stay (LOS), a surrogate for healthcare expenditure and an important short-term outcome measure.Research questionThe purpose of this study was to compare post-transplantation LOS over the last 3 decades.DesignA cross-sectional analysis of 150 603 adult liver transplant recipients between September 1987 and July 2021 from the UNOS database was conducted. The patients were placed into 3 eras (1987-1989, 1990-1999, and 2000-2021) based on a Join point regression analysis of significant time points of change in LOS trends. Risk factors that were significant in univariate analysis (<i>P</i> < .05) were included in the multivariable Cox regression analysis, which controlled for 29 donor/recipient characteristics.ResultsAmong adult patients, the average LOS following liver transplantation changed from 51.5 days in 1987 to 16.3 days in 2021, with a relatively steeper decline prior to 2000. On multivariable Cox regression, patients in both the 1987-1989 cohort (hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.52-0.57) and the 1990-1999 cohort (HR: 0.77, CI: 0.76-0.78) had significantly prolonged lengths of stay (HR < 1 associated with later hospital discharge) compared to the 2000-2021 cohort.ConclusionsThis analysis found that mean LOS decreased over time in adult liver transplant recipients, even after controlling for donor and recipient-level factors. Future studies are needed to elucidate root cause factors for this decline in LOS over time.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251327428"},"PeriodicalIF":0.6000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Progress in Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15269248251327428","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
IntroductionWhile survival following liver transplantation has improved over the past 3 decades, few studies have examined the changes over time in hospital length of stay (LOS), a surrogate for healthcare expenditure and an important short-term outcome measure.Research questionThe purpose of this study was to compare post-transplantation LOS over the last 3 decades.DesignA cross-sectional analysis of 150 603 adult liver transplant recipients between September 1987 and July 2021 from the UNOS database was conducted. The patients were placed into 3 eras (1987-1989, 1990-1999, and 2000-2021) based on a Join point regression analysis of significant time points of change in LOS trends. Risk factors that were significant in univariate analysis (P < .05) were included in the multivariable Cox regression analysis, which controlled for 29 donor/recipient characteristics.ResultsAmong adult patients, the average LOS following liver transplantation changed from 51.5 days in 1987 to 16.3 days in 2021, with a relatively steeper decline prior to 2000. On multivariable Cox regression, patients in both the 1987-1989 cohort (hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.52-0.57) and the 1990-1999 cohort (HR: 0.77, CI: 0.76-0.78) had significantly prolonged lengths of stay (HR < 1 associated with later hospital discharge) compared to the 2000-2021 cohort.ConclusionsThis analysis found that mean LOS decreased over time in adult liver transplant recipients, even after controlling for donor and recipient-level factors. Future studies are needed to elucidate root cause factors for this decline in LOS over time.
期刊介绍:
Progress in Transplantation (PIT) is the official journal of NATCO, The Organization for Transplant Professionals. Journal Partners include: Australasian Transplant Coordinators Association and Society for Transplant Social Workers. PIT reflects the multi-disciplinary team approach to procurement and clinical aspects of organ and tissue transplantation by providing a professional forum for exchange of the continually changing body of knowledge in transplantation.