title: The incidence and costs of sepsis and pneumonia before and after renal transplantation in the United States.
abstract: We compared the graft survival and accumulative costs associated with sepsis and pneumonia pre- and post-transplantation. We analyzed 44 916 first kidney transplants from 1995 to 2001 USRDS where Medicare was the primary payer. We drew five cohorts for each disease from the baseline population: patients who had a disease onset in the first or second years pre-transplantation (cohorts 1 and 2) or post-transplantation (cohorts 3 and 4) and patients who were disease-free (cohort 5). For each cohort, we calculated graft survival and average accumulated Medicare payments (AAMPs) for the two pre- and post-transplantation years. Graft survival: new-onset sepsis and pneumonia both significantly (p <0.01) lowered graft survival during the year of onset. AAMPs: the AAMPs incurred by sepsis- (pneumonia-) free patients during the first and second years post-transplantation were dollar 50,000 and 13,000 (dollar 51,100 and 13,500), respectively. Patients with a sepsis (pneumonia) onset post-transplantation cost on average dollar 48,400 (dollar 38,400) extra (p<0.01). Episodes of sepsis and pneumonia have a strong and independent impact on graft survival and costs.
authors.affiliation: University of New Hampshire, Durham, New Hampshire, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kutinova
authors.forename: R S
authors.initials: RS
authors.lastname: Woodward
authors.forename: J F
authors.initials: JF
authors.lastname: Ricci
authors.forename: D C
authors.initials: DC
authors.lastname: Brennan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D008297:Male; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D011014:Pneumonia / Q000191:economics* / Q000453:epidemiology*; D018805:Sepsis / Q000191:economics* / Q000453:epidemiology*; D014481:United States