Trends in postoperative outcomes and cost for live donor nephrectomies across surgical specialties

You have accessJournal of UrologyCME1 Apr 2023MP31-18 TRENDS IN POSTOPERATIVE OUTCOMES AND COST FOR LIVE DONOR NEPHRECTOMIES ACROSS SURGICAL SPECIALTIES Ilon Weinstein, Camilo Arenas-Gallo, Stephen Rhodes, and Jonathan Shoag Ilon WeinsteinIlon Weinstein More articles by this author , Camilo Arenas-GalloCamilo Arenas-Gallo More articles by this author , Stephen RhodesStephen Rhodes More articles by this author , and Jonathan ShoagJonathan Shoag More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003264.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Live donor nephrectomies (DN) were initially exclusively performed by urologists. Over time, general surgeons and transplant surgeons adopted DN into their scope of practice. Here, we investigate trends, postoperative complications, hospital length of stay, and cost across various surgical specialties performing DN. METHODS: Patients undergoing live DN from 2000-2020 were identified in the Premier Healthcare Database. Physician specialties were reported for each encounter, and patient and hospital characteristics for each specialty was compared. Multivariate logistic regression was used to assess association between physician specialty and postoperative complications and length of stay. Hospital charges and costs were log transformed and analyzed via linear mixed effects models. RESULTS: We identified 11,365 patients undergoing live DN by general surgery (n=3,922), urology (n=3,357), transplant surgery (n=3,123), and other (n=963). DN performed by urologists and transplant surgeons had similar odds ratios (OR) of complications compared to those performed by general surgery (0.91, p=0.4). The hospital length of stay for urology was similar to general surgery (incidence rate ratio (IRR) 1.03, p=0.12), and lower for transplant surgery (IRR 0.92, p<0.001). Urology had a slightly lower cost compared to general surgery ($11,666 vs $12,582) (Beta -0.08, p<0.001). CONCLUSIONS: Over the past two decades, general and transplant surgeons performed more DN with similar outcomes compared to urologists. From 2000-2020, there was an increase in annual numbers of DN performed by general and transplant surgeons and no significant differences in complications and length of stay between the surgical specialties. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e436 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ilon Weinstein More articles by this author Camilo Arenas-Gallo More articles by this author Stephen Rhodes More articles by this author Jonathan Shoag More articles by this author Expand All Advertisement PDF downloadLoading ...