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Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation.

Publication ,  Journal Article
Halpern, SE; Moris, D; Shaw, BI; Kesseli, SJ; Samoylova, ML; Manook, M; Schmitz, R; Collins, BH; Sanoff, SL; Ravindra, KV; Sudan, DL ...
Published in: World J Surg
May 2021

BACKGROUND: "Textbook outcome" (TO) is a novel composite quality measure that encompasses multiple postoperative endpoints, representing the ideal "textbook" hospitalization for complex surgical procedures. We defined TO for kidney transplantation using a cohort from a high-volume institution. METHODS: Adult patients who underwent isolated kidney transplantation at our institution between 2016 and 2019 were included. TO was defined by clinician consensus at our institution to include freedom from intraoperative complication, postoperative reintervention, 30-day intensive care unit or hospital readmission, length of stay > 75th percentile of kidney transplant patients, 90-day mortality, 30-day acute rejection, delayed graft function, and discharge with a Foley catheter. Recipient, operative, financial characteristics, and post-transplant patient, graft, and rejection-free survival were compared between patients who achieved and failed to achieve TO. RESULTS: A total of 557 kidney transplant patients were included. Of those, 245 (44%) achieved TO. The most common reasons for TO failure were delayed graft function (N = 157, 50%) and hospital readmission within 30 days (N = 155, 50%); the least common was mortality within 90 days (N = 6, 2%). Patient, graft, and rejection-free survival were significantly improved among patients who achieved TO. On average, patients who achieved TO incurred approximately $50,000 less in total inpatient charges compared to those who failed TO. CONCLUSIONS: TO in kidney transplantation was associated with favorable post-transplant outcomes and significant cost-savings. TO may offer transplant centers a detailed performance breakdown to identify aspects of perioperative care in need of process improvement.

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Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

May 2021

Volume

45

Issue

5

Start / End Page

1504 / 1513

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Quality Indicators, Health Care
  • Perioperative Care
  • Patient Readmission
  • Kidney Transplantation
  • Humans
  • Graft Survival
  • Graft Rejection
  • Adult
 

Citation

APA
Chicago
ICMJE
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Halpern, S. E., Moris, D., Shaw, B. I., Kesseli, S. J., Samoylova, M. L., Manook, M., … Barbas, A. S. (2021). Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation. World J Surg, 45(5), 1504–1513. https://doi.org/10.1007/s00268-020-05943-y
Halpern, Samantha E., Dimitrios Moris, Brian I. Shaw, Samuel J. Kesseli, Mariya L. Samoylova, Miriam Manook, Robin Schmitz, et al. “Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation.World J Surg 45, no. 5 (May 2021): 1504–13. https://doi.org/10.1007/s00268-020-05943-y.
Halpern SE, Moris D, Shaw BI, Kesseli SJ, Samoylova ML, Manook M, et al. Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation. World J Surg. 2021 May;45(5):1504–13.
Halpern, Samantha E., et al. “Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation.World J Surg, vol. 45, no. 5, May 2021, pp. 1504–13. Pubmed, doi:10.1007/s00268-020-05943-y.
Halpern SE, Moris D, Shaw BI, Kesseli SJ, Samoylova ML, Manook M, Schmitz R, Collins BH, Sanoff SL, Ravindra KV, Sudan DL, Knechtle SJ, Ellis MJ, McElroy LM, Barbas AS. Definition and Analysis of Textbook Outcome: A Novel Quality Measure in Kidney Transplantation. World J Surg. 2021 May;45(5):1504–1513.
Journal cover image

Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

May 2021

Volume

45

Issue

5

Start / End Page

1504 / 1513

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Quality Indicators, Health Care
  • Perioperative Care
  • Patient Readmission
  • Kidney Transplantation
  • Humans
  • Graft Survival
  • Graft Rejection
  • Adult