体外肺灌注对住院成本的影响：美国全国医疗保健成本和利用项目数据库的倾向评分匹配分析

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-01-28 DOI:10.1111/ctr.70096

Victoria Yin, Scott M. Atay, John C. S. Rodman, Sean C. Wightman, Graeme M. Rosenberg, Brooks V. Udelsman, Anthony W. Kim, Takashi Harano

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引用次数: 0

摘要

背景：本研究的目的是调查全国范围内肺移植患者体外肺灌注（EVLP）使用与住院费用之间的关系。方法：根据EVLP的使用情况对2018-2020年全国再入院数据库（NRD）的肺移植患者进行分组。主要观察指标为住院总费用。通过EVLP状态进行1:2倾向评分匹配，然后进行多变量线性回归，在调整移植前住院天数、高容量EVLP中心状态和倾向评分的情况下，确定住院费用与EVLP之间的关系。结果：肺移植3902例，EVLP肺移植118例（3%）。EVLP患者的中位成本为871 468美元（IQR: 608 671-1 274 392美元），而非EVLP患者的中位成本为846 516美元（IQR: 531 462-1 439 267美元，p = 0.871）。在1:2倾向评分匹配队列后，EVLP肺受者的中位住院时间更长（p = 0.046）。在使用匹配样本的多变量模型中，成本增加与EVLP的使用无关（p = 0.783）；然而，高容量EVLP中心与成本降低相关（p = 0.018）。结论：EVLP的使用与更高的住院费用无关，在大容量中心可能是有利的。

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Impact of Ex Vivo Lung Perfusion on Inpatient Cost: A Propensity Score-Matched Analysis of the US Nationwide Healthcare Cost and Utilization Project Database

Background

The goal of this study was to investigate the association between ex vivo lung perfusion (EVLP) use and inpatient hospitalization cost for lung transplantation in a nationwide sample.

Methods

Lung transplantation patients in 2018–2020 Nationwide Readmissions Database (NRD) were grouped based on use of EVLP. The primary outcome was total inpatient hospitalization cost. 1:2 propensity score matching by EVLP status was performed followed by multivariable linear regression to determine the association between inpatient cost and EVLP while adjusting for pre-transplant hospital days, high volume EVLP center status, and propensity score.

Results

There were 3902 lung transplants and 118 (3%) were recipients of EVLP lungs. Among EVLP patients, the median cost was $871 468 (IQR: $608 671–1 274 392), compared to $846 516 (IQR: $531 462–1 439 267, p = 0.871) among the total non-EVLP cohort. After 1:2 propensity score-matched cohort, recipients of EVLP lungs had longer median hospital length of stay (p = 0.046). In the multivariable model using the matched sample, increased cost was not associated with EVLP use (p = 0.783); however, high volume EVLP centers were associated with decreased cost (p = 0.018).

Conclusions

EVLP use was not associated with greater inpatient costs and may be favorable at high volume centers.

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.