H. Albershri1, W. Qu1, M. Nazzal1, J. Ortiz1 1The University Of Toledo Medical Center,Department Of Surgery,Toledo, OH, USA
Objectives: To investigate the impacts of history of kidney transplant (Tx) on the in-hospital outcomes of surgical repair (SR) of abdominal aortic aneurysm (AAA).
Methods: All AAA patients from 2008 to 2013 were selected using International Classification of Diseases rev.9 (ICD-9) codes from the National Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project (HCUP). History of Tx, comorbidities, SR (open (OR) or endovascular repair (EVAAAR)) and postoperative complications were also identified by ICD-9 codes. Elixhauser comorbidity index (ECI) were calculated based on the method published by van Walraven, et al. In-hospital mortality rate (IMR), length of stay (LOS), total hospital charge (TC) and postoperative complications were compared between Tx and No Tx patients. Binary logistic regression and linear regression were used to adjust for the confounding factors. IBM SPSS ver.23 was used in all the statistical analysis. Type I error level was set at 0.05.
Results: 284451 patients in NIS were diagnosed with AAA in 6 years. Only 389 (0.14%) of them had a history of Tx. Tx patients were significantly younger (67.8±9.5 vs. 75.9±10 years old) and had more males (78.1% vs. 67.4%) than non-Tx patients (both p<.001). Among 18.3% (n=52168) of the patients who underwent SR, the majority of the procedures were EVAAAR (78.3%). There were no significant differences in incidence and types of SR between Tx and Non-Tx patients (Table 1, both p>.05). Tx group had significantly higher ECI than that of the non-Tx group (median: 6 vs. 2, p<.001). There were no significant differences in common postoperative complications, LOS, TC and IMR between Tx and non-Tx patients (Table 1, all p>.05). Multivariable analysis results also showed no significant differences in these in-hospital outcomes between Tx and non-Tx group after adjusting for confounding factors such as demographics, hospital characteristics and ECI (Table 1, all p>.05).
Conclusion: Despite the fact that Tx patients tend to have a higher rate of comorbidities, they did not show significant increases in postoperative complication rates, IMR, LOS and TC than that of the non-Tx patients. Our study is limited to the in-hospital outcomes and the statistical power was not satisfactory due to the small sample size in Tx group.
