Abstract | INTRODUCTION:
Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative shortage of donor grafts, worse post- transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure. AIM: To determine if patients ≥ 60 years of age utilize more health resources following liver transplantation compared with younger patients. MATERIAL AND METHODS: Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over a 2.5-year period. Data were collected on clinico-demographic characteristics and resource utilization. Descriptive statistics, including means, standard deviations, or frequencies were obtained for baseline variables. Patients were stratified into 2 groups: age ≥ 60 years (n = 51) and < 60 years (n = 157). The Chi-Square Test, Mantel-Haenszel Test, 2-sample test and odds ratios were calculated to ascertain associations between age and resource utilization parameters. Regression analyses were adjusted for model for end-stage liver disease score, location before surgery, diabetes mellitus, donor age, cold ischemia time, albumin, and diagnosis of hepatitis C. RESULTS: Recipients ≥ 60 years of age have similar lengths of hospitalization, re-operative rates, need for consultative services and readmission rates following liver transplantation, but have longer lengths of stay in the intensive care (hazard ratio 1.97, p = 0.03). CONCLUSION: Overall, liver transplant recipients ≥ 60 years of age utilize comparable resources following LT vs. younger recipients. Our findings have implications on cost-containment policies for liver transplantation.
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Authors | Neil Shankar, Mamoun AlBasheer, Paul Marotta, William Wall, Vivian McAlister, Natasha Chandok |
Journal | Annals of hepatology
(Ann Hepatol)
2011 Oct-Dec
Vol. 10
Issue 4
Pg. 477-81
ISSN: 1665-2681 [Print] Mexico |
PMID | 21911888
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adult
- Age Factors
- Aged
- Chi-Square Distribution
- Critical Care
(statistics & numerical data)
- Delivery of Health Care
(economics, statistics & numerical data)
- Female
- Health Resources
(economics, statistics & numerical data)
- Humans
- Length of Stay
- Liver Transplantation
(adverse effects, economics)
- Male
- Middle Aged
- Odds Ratio
- Ontario
- Patient Readmission
- Referral and Consultation
(statistics & numerical data)
- Regression Analysis
- Reoperation
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
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