| アブストラクト | Living-donor lobar lung transplantation (LDLLT) is a well-established surgical procedure with favorable outcomes; however, the frequency of readmission and costs in LDLLT are poorly understood. Here, we aimed to compare health care costs and readmissions at 90 days and 1 year after the index discharge in LDLLT and cadaveric lung transplantation (CLT) and evaluate the reasons for readmission and in-hospital mortality. In this retrospective cohort study, we used the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan to obtain initial lung transplantation data for all patients from July 2010 to March 2020. Multivariable Poisson or multiple regression analyses after multiple imputation was performed to compare the cumulative number of readmissions and costs between patients receiving LDLLT and CLT. Among 514 recipients, 115 (22%) underwent LDLLT and 399 (78%) received CLT. Overall, in-hospital mortality after transplantation was 4.5%. The LDLLT group showed a significantly lower crude readmission rate (90 days, 22% vs 37%, p = 0.004; 1 year, 48% vs 62%, p = 0.031) and median readmission cost (90 days, United States dollar (USD) 0 vs 0, p = 0.003; 1 year, USD 1178 vs 4714, p = 0.005) than the CLT group. Multivariable regression analyses showed that the LDLLT group had a lower risk of readmission (incidence rate ratio, 0.59; 95% confidence interval, 0.38-0.92; p = 0.020) and lower costs at 90 days (difference, USD -11,629; 95% confidence interval, -5682 to -17,462; p < 0.001). The most frequent cause of readmission was pneumonia in both groups. LDLLT was associated with lower readmissions and health care costs in comparison with CLT. Our findings provide a scientific basis for further studies with larger cohorts. |
|---|
| ジャーナル名 | JHLT open |
|---|
| Pubmed追加日 | 2023/10/11 |
|---|
| 投稿者 | Yoshiyasu, Nobuyuki; Jo, Taisuke; Sato, Masaaki; Kumazawa, Ryosuke; Matsui, Hiroki; Fushimi, Kiyohide; Nagase, Takahide; Yasunaga, Hideo; Nakajima, Jun |
|---|
| 組織名 | Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.;Department of Respiratory Medicine, Graduate School of Medicine, The University;of Tokyo, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Organ Transplantation Center, The University of Tokyo Hospital, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medical and Dental Sciences, Tokyo, Japan. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40144015/ |
|---|
