Introduction:

Never Events (NE) and Hospital Acquired Conditions (HAC) after surgery have been designated as quality metrics in health care by the centers for Medicare and Medicaid Services (CMS).

Methods:

The NIS database 2002-2012 was used to identify patients who underwent kidney transplant. Multivariate analysis using logistic regression was used to identify outcomes and risk factors of HAC and NE after transplant.

Results:

Among 172,586 patients who underwent kidney transplant alone there were 48 Never Events, all of which were due to retained foreign bodies. Among HAC after surgery, falling was the most common (42%) followed by poor glycemic control (21%), vascular catheter-associated infection (19%), catheter-associated urinary tract infection (7%), stages III & IV pressure ulcers (3%), and ABO incompatible blood transfusion (2%). HAC and NE after surgery lead to a significantly increased length of stay (13 days vs. 7 days, P<0.01), hospital charges ($233128 vs. $147312, P<0.01), mortality (AOR: 2.78, P<0.01), and a trend towards increased need for reoperation (AOR: 2.05, P<0.01). A significantly higher risk of HAC or NE events was seen for patients who were expected to have higher mortality (AOR: 1.51, P=0.01) and morbidity (AOR: 2.02, P<0.01) before operation.

Conclusions:

HAC and NE after kidney transplant are uncommon, but they are associated with a significant increase in mortality, hospitalization length of stay, hospital charges, and reoperation of patients. Quality improvement initiatives should target HAC and NE in order to successfully reduce or prevent these events.

CITATION INFORMATION: Moghadamyeghaneh Z, Alameddine M, Burke G, Ciancio G, Chen L. Never Events and Hospital Acquired Conditions After Kidney Transplant. Am J Transplant. 2016;16 (suppl 3).

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