title: The impact of morbid obesity on hospital length of stay in kidney transplant recipients.
abstract: OBJECTIVE
  Obesity is often associated with higher hospital costs because of longer length of stay (LOS) but this has not been well studied in the kidney transplant population. Therefore, we used national data to compare LOS in select groups of morbidly obese and normal weight recipients after kidney transplant.
  
  
  METHODS
  This study was a retrospective analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing database.
  
  
  METHODS
  The study sample consisted of 42,787 morbidly obese (body mass index 35-40 kg/m(2)) and normal weight (body mass index 18.5-24.9 kg/m(2)) who underwent primary kidney-only transplantation between 2000 and 2008.
  
  
  METHODS
  Morbidly obese and normal-weight subgroups were crudely evaluated for prolonged LOS (>7 days). Logistic regression modeling compared LOS in morbidly obese and normal-weight subgroups with varying characteristics and determined predictors of prolonged LOS.
  
  
  RESULTS
  All morbidly obese subgroups had significantly higher crude rates of prolonged LOS (P < .05). However, no significant differences in prolonged LOS were seen between any of the morbidly obese or normal-weight subgroups in multivariate analysis. Morbid obesity was an independent predictor of prolonged LOS (P < .001) but not a stronger predictor than that of being African American, having coronary artery disease, diabetes mellitus, or peripheral vascular disease, being 50 to 80 years of age, having a previous transplant or poor functional status. Receiving a deceased-donor transplant and being dialysis dependent >4 years were significantly better predictors of prolonged LOS compared with morbid obesity (P < .05).
  
  
  CONCLUSIONS
  Some morbidly obese populations have LOS rates that are not significantly different than many commonly transplanted normal weight populations, and the impact morbid obesity has on LOS is not different than many other factors often seen in kidney transplant recipients; therefore, morbid obesity alone should not be a financial consideration in kidney transplant.
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey. Electronic address: daniel.pieloch@rwjuh.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pieloch
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Richard
authors.initials: R
authors.lastname: Mann
authors.affiliation: Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Viktor
authors.initials: V
authors.lastname: Dombrovskiy
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Meelie
authors.initials: M
authors.lastname: DebRoy
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Adena J
authors.initials: AJ
authors.lastname: Osband
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Zahidul
authors.initials: Z
authors.lastname: Mondal
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Sonalis
authors.initials: S
authors.lastname: Fernandez
authors.affiliation: The Transplant Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: David A
authors.initials: DA
authors.lastname: Laskow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D066027:Transplant Recipients; D055815:Young Adult