Surgical approach, cost, and complications of appendectomy in kidney transplant recipients

Sandra R. DiBrito, Israel O. Olorundare, Courtenay M. Holscher, Claudia S. Landazabal, Babak J. Orandi, Nabil N. Dagher, Dorry L. Segev, Jacqueline Garonzik-Wang

Research output: Contribution to journalArticlepeer-review

Abstract

Kidney transplant recipients (KTRs) have greater morbidity and length of stay (LOS) following certain surgical procedures than non-KTR. Given that appendectomy is one of the most common surgical procedures, we investigated differences in outcomes between 1336 KTR and 2 640 247 non-KTR postappendectomy at transplant and nontransplant centers in the United States from 2000 to 2011, using NIS data and adjusting for patient-level and hospital-level factors. Postoperative complications were identified using ICD-9 codes. Among KTR, there were no post-appendectomy in-hospital deaths, compared to a 0.2% in non-KTR (P =.5). Overall complications were similar among KTR and non-KTR (17.0% vs 11.6%; aOR: 0.77 1.12 1.61 ). LOS and costs were greater for KTR compared to non-KTR (LOS ratio 1.19 1.31 1.45 ; cost ratio 1.11 1.17 1.26 ). Only 44.8% of KTR had laparoscopic approach compared to 54.5% of non-KTR, but had similar complication rates (10.6 vs 8.7%, P =.5). When treated at transplant centers, KTR had similar complications (aOR 0.44 0.79 1.43 ), but longer LOS (ratio 1.21 1.37 1.55 ) and greater hospital-associated costs (ratio 1.19 1.29 1.41 ) than non-KTR. Conversely, at nontransplant centers, KTR and non-KTR had similar complications (aOR 0.75 1.23 2.0 ), LOS (ratio 0.84 0.96 1.09 ), and cost (ratio 0.93 1.01 1.10 ). Contrary to other procedures, KTR did not constitute a high-risk group for patients undergoing appendectomy.

Original languageEnglish (US)
Article numbere13245
JournalClinical Transplantation
Volume32
Issue number5
DOIs
StatePublished - May 2018

Keywords

  • appendectomy
  • general surgery
  • kidney transplantation

ASJC Scopus subject areas

  • Transplantation

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