Never events and hospital-Acquired conditions after kidney transplant

Zhobin Moghadamyeghaneh, Linda J Chen, Mahmoud Alameddine, Anupam K. Gupta, George W Burke, Gaetano Ciancio

Research output: Contribution to journalArticle

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Abstract

Introduction: Never events (NE) and hospital-Acquired conditions (HAC) after surgery have been designated as quality metrics in healthcare by the Centres for Medicare and Medicaid Services (CMS). Methods: The Nationwide Inpatient Sample (NIS) database 2002?2012 was used to identify patientswho underwent kidney transplant. Multivariate analysis using logistic regression was used to identify outcomes and risk factors of HAC and NE after transplantation; however, we were limited by using a retrospective database missing some important variables specified for the kidney transplant, such as some operative factors, donor factors, and cold and warm ischemia times. Results: Among 35 058 patients who underwent kidney transplant, there were 11 NEs, all of which were due to retained foreign bodies. Among HAC after surgery, falling was the most common (44.9%), followed by poor glycemic control (21.7%), vascular catheter-Associated infection (21%), and catheter-Associated urinary tract infection (8%). HAC and NE after surgery lead to a significant increase in mortality (adjusted odds ratio [AOR] 2.49; p=0.04), hospitalization length (13 vs. 7 days; p<0.01), and total hospital charges ($231 801 vs. $146 717; p<0.01). A significantly higher risk of HAC or NE was seen for patients who had more loss of function before surgey (AOR 3.25; p<0.01) and patients expected to have higher postoperative mortality before operation (AOR 1.62; p=0.03). Conclusions: Despite the limitations of the study, we found HAC and NE significantly increase mortality, hospitalization length, and total hospital charges of kidney transplant patients. Quality improvement initiatives should target HAC and NE in order to successfully reduce or prevent these events.

Original languageEnglish (US)
Pages (from-to)E431-436
JournalCanadian Urological Association Journal
Volume11
Issue number11
DOIs
StatePublished - Nov 1 2017

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Iatrogenic Disease
Medical Errors
Transplants
Kidney
Hospital Charges
Catheter-Related Infections
Odds Ratio
Mortality
Hospitalization
Accidental Falls
Databases
Cold Ischemia
Centers for Medicare and Medicaid Services (U.S.)
Warm Ischemia
Vascular Access Devices
Quality Improvement
Foreign Bodies
Urinary Tract Infections
Inpatients
Multivariate Analysis

ASJC Scopus subject areas

  • Urology

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Never events and hospital-Acquired conditions after kidney transplant. / Moghadamyeghaneh, Zhobin; Chen, Linda J; Alameddine, Mahmoud; Gupta, Anupam K.; Burke, George W; Ciancio, Gaetano.

In: Canadian Urological Association Journal, Vol. 11, No. 11, 01.11.2017, p. E431-436.

Research output: Contribution to journalArticle

Moghadamyeghaneh, Zhobin ; Chen, Linda J ; Alameddine, Mahmoud ; Gupta, Anupam K. ; Burke, George W ; Ciancio, Gaetano. / Never events and hospital-Acquired conditions after kidney transplant. In: Canadian Urological Association Journal. 2017 ; Vol. 11, No. 11. pp. E431-436.
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