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©The Author(s) 2024.
World J Transplant. Jun 18, 2024; 14(2): 90866
Published online Jun 18, 2024. doi: 10.5500/wjt.v14.i2.90866
Published online Jun 18, 2024. doi: 10.5500/wjt.v14.i2.90866
Factor | 2019 | 2020 | P value |
Total liver transplant hospitalizations | 7810 (49.7) | 7910 (50.3) | |
Liver transplant rejections | 120 (1.5) | 180 (2.3) | < 0.001 |
Elixhauser comorbidity index score | < 0.001 | ||
≤ 2 | 325 (4.2) | 235 (3.0) | |
≥ 3 | 7490 (95.8) | 7680 (97.0) | |
Age in years at admission, median (IQR) | 57.0 (49.0, 64.0) | 57.0 (48.0, 64.0) | 0.75 |
Gender | 0.90 | ||
Male | 4885 (62.51) | 4940 (62.41) | |
Female | 2930 (37.49) | 2975 (37.59) | |
Median household income national quartile for patient ZIP code | < 0.001 | ||
1st (0-25th) | 1770 (23.2) | 1935 (24.8) | |
2nd (26th-50th) | 1850 (24.2) | 2070 (26.6) | |
3rd (51st-75th) | 2115 (27.7) | 1830 (23.5) | |
4th (76th-100th) | 1905 (24.9) | 1955 (25.1) | |
Primary payer | 0.39 | ||
Medicare | 2405 (32.2) | 2345 (31.0) | |
Medicaid | 1205 (16.1) | 1260 (16.7) | |
Private and other | 3943 (50.5) | 3991 (50.5) | |
Inpatient mortality | 210 (2.7) | 250 (3.2) | 0.079 |
Length of stay (d), median (IQR) | 12.0 (7.0, 23.0) | 12.0 (8.0, 24.0) | 0.2 |
Total charges (USD), median (IQR) | 428177.0 (307282.0, 689844.0) | 473252.0 (334552.0, 744322.0) | < 0.001 |
Jan | Feb | March | April | May | June | July | Aug | Sep | Oct | Nov | Dec | P value | |
Total liver transplant hospitalizations, n (%) | |||||||||||||
2019 | 600 (7.7) | 635 (8.1) | 690 (8.8) | 625 (8.0) | 615 (7.9) | 675 (8.6) | 670 (8.6) | 710 (9.1) | 685 (8.8) | 705 (9.0) | 600 (7.7) | 635 (8.1) | 0.98 |
2020 | 635 (8.0) | 655 (8.3) | 560 (7.1) | 595 (7.5) | 700 (8.9) | 710 (9.0) | 670 (8.5) | 695 (8.8) | 690 (8.7) | 650 (8.2) | 665 (8.4) | 685 (8.7) | 0.73 |
Liver transplant rejections, n (%) | |||||||||||||
2019 | < 10 | 35 (5.5) | 30 (4.3) | 25 (4.0) | 25 (4.1) | < 10 | 15 (2.2) | 15 (2.1) | < 10 | 15 (2.1) | < 10 | < 10 | < 0.001 |
2020 | < 10 | 35 (5.3) | 15 (2.7) | 15 (2.5) | 15 (2.1) | < 10 | 25 (3.7) | < 10 | < 10 | 15 (2.3) | < 10 | 25 (3.6) | 0.23 |
Elixhauser comorbidity index score, n (%) | |||||||||||||
2019 | < 0.001 | ||||||||||||
≤ 2 | 30 (5) | 35 (5.5) | 30 (4.3) | 20 (3.2) | 30 (4.9) | 45 (6.7) | 15 (2.2) | 25 (3.5) | 20 (2.9) | 15 (2.1) | 30 (5.2) | 30 (4.8) | |
≥ 3 | 570 (95.0) | 600 (94.5) | 660 (95.7) | 605 (96.8) | 585 (95.1) | 630 (93.3) | 655 (97.8) | 685 (96.5) | 665 (97.1) | 690 (97.9) | 545 (94.8) | 595 (95.2) | |
2020 | < 0.001 | ||||||||||||
≤ 2 | 35 (5.5) | 20 (3.1) | 20 (3.6) | 15 (2.5) | 30 (4.3) | 25 (3.5) | 0 (0.0) | 20 (2.9) | < 10 | 30 (4.6) | 15 (2.3) | < 10 | |
≥ 3 | 600 (94.5) | 635 (96.9) | 540 (96.4) | 580 (97.5) | 670 (95.7) | 685 (96.5) | 665 (99.3) | 675 (97.1) | 680 (98.6) | 620 (95.4) | 650 (97.7) | 675 (98.5) | |
Age in years at admission, median (IQR) | |||||||||||||
2019 | 58.5 (52.0, 65.0) | 57.0 (49.0, 63.0) | 57.0 (46.0, 62.0) | 57.0 (50.0, 64.0) | 57.0 (49.0, 63.0) | 58.0 (50.0, 64.0) | 59.0 (49.0, 63.0) | 57.0 (48.0, 65.0) | 57.0 (51.0, 65.0) | 57.0 (47.0, 62.0) | 58.0 (50.0, 66.0) | 56.0 (48.0, 63.0) | < 0.001 |
2020 | 58.0 (49.0, 64.0) | 55.0 (46.0, 64.0) | 57.0 (50.0, 64.0) | 59.0 (47.0, 65.0) | 57.0 (49.5, 64.0) | 57.0 (45.0, 64.0) | 56.0 (42.0, 63.0) | 57.0 (48.0, 64.0) | 58.0 (49.0, 65.0) | 57.0 (47.0, 64.0) | 58.0 (49.0, 64.0) | 59.0 (48.0, 65.0) | < 0.001 |
Gender, n (%) | |||||||||||||
2019 | < 0.001 | ||||||||||||
Male | 380 (63.3) | 390 (61.4) | 415 (60.1) | 375 (60.0) | 345 (56.1) | 445 (65.9) | 425 (63.4) | 495 (69.7) | 440 (64.2) | 450 (63.8) | 375 (65.2) | 350 (56.0) | |
Female | 220 (36.7) | 245 (38.6) | 275 (39.9) | 250 (40.0) | 270 (43.9) | 230 (34.1) | 245 (36.6) | 215 (30.3) | 245 (35.8) | 255 (36.2) | 200 (34.8) | 275 (44.0) | |
2020 | 0.037 | ||||||||||||
Male | 415 (65.4) | 400 (61.1) | 350 (62.5) | 410 (68.9) | 415 (59.3) | 410 (57.7) | 385 (57.5) | 465 (66.9) | 455 (65.9) | 440 (67.7) | 395 (59.4) | 400 (58.4) | |
Female | 220 (34.6) | 255 (38.9) | 210 (37.5) | 185 (31.1) | 285 (40.7) | 300 (42.3) | 285 (42.5) | 230 (33.1) | 235 (34.1) | 210 (32.3) | 270 (40.6) | 285 (41.6) | |
Median household income national quartile for patient ZIP Code, n (%) | |||||||||||||
2019 | < 0.001 | ||||||||||||
1st (0-25th) | 115 (20.4) | 105 (17.1) | 145 (21.8) | 180 (29.0) | 140 (22.8) | 145 (21.8) | 195 (29.8) | 150 (21.6) | 185 (27.6) | 140 (20.0) | 135 (24.1) | 135 (22.1) | |
2nd (26th-50th) | 140 (24.8) | 190 (30.9) | 125 (18.8) | 145 (23.4) | 165 (26.8) | 150 (22.6) | 145 (22.1) | 150 (21.6) | 145 (21.6) | 165 (23.6) | 150 (26.8) | 180 (29.5) | |
3rd (51st-75th) | 160 (28.3) | 155 (25.2) | 220 (33.1) | 180 (29.0) | 150 (24.4) | 175 (26.3) | 175 (26.7) | 185 (26.6) | 175 (26.1) | 195 (27.9) | 165 (29.5) | 175 (28.7) | |
4th (76th-100th) | 150 (26.5) | 165 (26.8) | 175 (26.3) | 115 (18.5) | 160 (26.0) | 195 (29.3) | 140 (21.4) | 210 (30.2) | 165 (24.6) | 200 (28.6) | 110 (19.6) | 120 (19.7) | |
2020 | < 0.001 | ||||||||||||
1st (0-25th) | 165 (26.4) | 130 (20.2) | 150 (26.8) | 135 (23.1) | 175 (25.5) | 165 (23.6) | 150 (22.6) | 220 (32.1) | 180 (26.1) | 175 (27.6) | 155 (23.5) | 135 (20.6) | |
2nd (26th-50th) | 205 (32.8) | 180 (27.9) | 140 (25.0) | 150 (25.6) | 195 (28.5) | 190 (27.1) | 230 (34.6) | 155 (22.6) | 170 (24.6) | 135 (21.3) | 180 (27.3) | 140 (21.4) | |
3rd (51st-75th) | 110 (17.6) | 130 (20.2) | 160 (28.6) | 150 (25.6) | 160 (23.4) | 170 (24.3) | 130 (19.5) | 150 (21.9) | 165 (23.9) | 175 (27.6) | 130 (19.7) | 200 (30.5) | |
4th (76th-100th) | 145 (23.2) | 205 (31.8) | 110 (19.6) | 150 (25.6) | 155 (22.6) | 175 (25.0) | 155 (23.3) | 160 (23.4) | 175 (25.4) | 150 (23.6) | 195 (29.5) | 180 (27.5) | |
Primary payer, n (%) | |||||||||||||
2019 | < 0.001 | ||||||||||||
Medicare | 190 (33.0) | 170 (28.3) | 220 (33.3) | 155 (25.4) | 180 (30.8) | 225 (34.9) | 210 (31.8) | 245 (36.0) | 220 (33.6) | 215 (32.6) | 195 (36.8) | 180 (30.0) | |
Medicaid | 85 (14.8) | 100 (16.7) | 95 (14.4) | 120 (19.7) | 95 (16.2) | 105 (16.3) | 110 (16.7) | 110 (16.2) | 110 (16.8) | 120 (18.2) | 65 (12.3) | 85 (14.2) | |
Private and other | 300 (50.0) | 330 (52.0) | 345 (50.0) | 335 (54.9) | 310 (50.4) | 315 (46.7) | 340 (51.5) | 339 (47.7) | 340 (49.6) | 347 (49.2) | 293 (50.9) | 349 (55.8) | |
2020 | < 0.001 | ||||||||||||
Medicare | 215 (35.0) | 185 (30.8) | 190 (35.5) | 200 (35.1) | 185 (27.8) | 175 (25.7) | 190 (30.4) | 200 (29.9) | 210 (32.1) | 200 (32.3) | 190 (29.2) | 200 (29.9) | |
Medicaid | 90 (14.6) | 135 (22.5) | 60 (11.2) | 90 (15.8) | 105 (15.8) | 105 (15.4) | 115 (18.4) | 140 (20.9) | 95 (14.5) | 110 (17.7) | 100 (15.4) | 115 (17.2) | |
Private and other | 310 (48.8) | 280 (46.7) | 285 (53.3) | 280 (47.1) | 375 (56.4) | 400 (58.8) | 320 (47.8) | 330 (47.5) | 350 (50.7) | 310 (47.7) | 369 (55.5) | 355 (53.0) | |
Inpatient mortality, n (%) | |||||||||||||
2019 | < 10 | 20 (3.1) | < 10 | 30 (4.8) | 15 (2.4) | 25 (3.7) | 15 (2.2) | 25 (3.5) | 15 (2.2) | 25 (3.5) | 15 (2.6) | < 10 | 0.78 |
2020 | < 10 | 25 (3.8) | < 10 | 45 (7.6) | 15 (2.1) | 25 (3.5) | 15 (2.2) | 25 (3.6) | 15 (2.2) | 15 (2.3) | 20 (3.0) | 30 (4.4) | 0.55 |
Length of stay, median (IQR) (days) | |||||||||||||
2019 | 12.5 (8.0, 25.5) | 11.0 (7.0, 25.0) | 11.0 (7.0, 23.0) | 11.0 (7.0, 21.0) | 11.0 (7.0, 17.0) | 12.0 (7.0, 23.0) | 14.0 (9.0, 25.0) | 12.0 (7.0, 23.0) | 11.0 (8.0, 23.0) | 14.0 (7.0, 21.0) | 11.0 (8.0, 24.0) | 13.0 (8.0, 23.0) | < 0.001 |
2020 | 12.0 (7.0, 25.0) | 12.0 (8.0, 21.0) | 11.5 (7.0, 23.0) | 13.0 (8.0, 24.0) | 11.5 (8.0, 23.0) | 11.5 (7.0, 21.0) | 11.0 (7.0, 20.0) | 15.0 (8.0, 26.0) | 13.0 (8.0, 24.0) | 14.5 (8.0, 30.0) | 13.0 (8.0, 23.0) | 13.0 (8.0, 25.0) | < 0.001 |
Total charges, median (IQR) (USD) | |||||||||||||
2019 | 438680.5 (319902.0, 703305.0) | 383767.0 (292185.0, 648388.0) | 394906.0 (290243.0, 740556.0) | 416119.0 (308253.0, 670906.0) | 397547.0 (294459.0, 607369.0) | 408327.0 (314639.0, 669496.0) | 475886.0 (319526.0, 770702.0) | 461861.0 (294480.0, 644659.0) | 419143.0 (313531.0, 641207.0) | 449383.0 (326746.0, 702840.5) | 430862.0 (293962.0, 644716.0) | 428974.0 (308548.0, 780206.0) | < 0.001 |
2020 | 442761.5 (303964.0, 677788.0) | 465051.0 (340561.0, 685720.0) | 442387.0 (329722.0, 705312.0) | 476185.0 (340632.0, 652454.0) | 435817.0 (328502.0, 714647.0) | 457076.0 (347943.5, 676989.0) | 456924.0 (331853.5, 664905.5) | 515565.0 (369134.0, 806652.0) | 481444.0 (327361.0, 726893.0) | 523452.0 (339184.0, 951676.0) | 505836.0 (330019.5, 796788.0) | 451569.0 (325468.0, 754506.0) | < 0.001 |
COVID-19 Dx (2020 only), n (%) | 0 (0.0) | 0 (0.0) | < 10 | < 10 | < 10 | < 10 | < 10 | 0 (0.0) | < 10 | 0 (0.0) | 20 (3.0) | < 10 | 0.10 |
- Citation: Inayat F, Patel P, Ali H, Afzal A, Tahir H, Chaudhry A, Ishtiaq R, Rehman AU, Darji K, Afzal MS, Nawaz G, Giammarino A, Satapathy SK. Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality. World J Transplant 2024; 14(2): 90866
- URL: https://www.wjgnet.com/2220-3230/full/v14/i2/90866.htm
- DOI: https://dx.doi.org/10.5500/wjt.v14.i2.90866