title: The impact of morbid obesity on resource utilization after renal transplantation.
abstract: A growing number of renal transplant recipients have a body mass index ≥40. While previous studies have shown that patient and graft survival are significantly decreased in renal transplant recipients with body mass indexes ≥40, less is known about perioperative outcomes and resource utilization in morbidly obese patients. We aimed to analyze the effects of morbid obesity on these parameters in renal transplant.
  
  
  
  Using a linkage between the Scientific Registry of Transplant Recipients and the databases of the University HealthSystem Consortium, we identified 29,728 adult renal transplant recipients and divided them into 2 cohorts based on body mass index (<40 vs ≥40 kg/m2). The body mass index ≥40 group comprised 2.5% (n = 747) of renal transplant recipients studied.
  
  
  
  Body mass index ≥40 recipients incurred greater direct costs ($84,075 vs $79,580, P < .01), index admission costs ($91,169 vs $86,141, P < .01), readmission costs ($5,306 vs $4,596, P = .01), and combined costs ($99,590 vs $93,939, P < .001). Thirty-day readmission rates were also greater among body mass index ≥40 recipients (33.92% vs 26.9%, P < .01). Morbid obesity was not predictive of stay (odds ratio 1.01, P = .75).
  
  
  
  Morbidly obese renal transplant recipients incur greater costs and readmission rates compared with nonobese patients. Recognition of increased resource utilization should be accompanied by appropriate, risk-adjustment reimbursement.
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Young
authors: Y
authors: Kim
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Alex L
authors: AL
authors: Chang
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Koffi
authors: K
authors: Wima
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Audrey E
authors: AE
authors: Ertel
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Tayyab S
authors: TS
authors: Diwan
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Daniel E
authors: DE
authors: Abbott
authors: Cincinnati Research in Outcomes and Safety in Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: Shimul.shah@uc.edu.
authors: Shimul A
authors: SA
authors: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004180:Direct Service Costs; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000401:mortality; D011182:Postoperative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult