Introducción: La enfermedad renal crónica es una pandemia que afecta al 10%
de la población adulta. La relación costo beneficio de trasplante es buena. No
obstante, es importante reducir los costos de atención en la medida posible y una
posibilidad es disminuyendo la estancia hospitalaria. Objetivo: Evaluar que
factores se asocian con aumento en días de estancia y costos de pacientes post -
operados de trasplante renal. Material y métodos: Se realizó un estudio
observacional, transversal, retrospectivo, en pacientes post operados de trasplante
renal en el Centenario Hospital Miguel Hidalgo. Resultados: Se incluyeron 98
pacientes post-trasplantados de riñón en el CHMH, 56 ingresaron al servicio de
Cirugía General y el restante 42 a la Unidad de Cuidados Intensivos (UCI). Entre
los pacientes con cuidados post-operatorios en la UCI el tiempo de estancia fue
4.0±0.9 días en comparación con el servicio de Cirugía General, donde la
estancia hospitalaria media fue 4.2±1.5 días (p=0.674). Los costos globales de
atención en los pacientes ingresados a la UCI fueron $84074.8±13707.8 MXN y
entre los pacientes atendidos por el servicio de Cirugía General fueron
$76329.6±21291.3 (p=0.201). La estancia hospitalaria fue mayor en los que
recibieron cuidados post-operatorios en UCI (5.1±2.0 días) que en Cirugía General
(4.5±2.6 días); el costo de atención total fue de $88,869.49 en los ingresados a
UCI en compración con cirugía general $80.292.33. Conclusiones: En pacientes
con complicaciones transoperatorias, los que recibieron cuidados post -operatorios
en UCI tuvieron mayor tiempo de estancia hospitalaria y mayores costos de
atención promedio.
Palabras clave: Enfermedad renal crónica, Trasplante renal, Donador vivo, Costo
de atención hospitalaria.
Introduction: Chronic kidney disease is a pandemic that affects about 10% of the
adult population globally. The cost of transplantation is high, although its costbenefit
ratio is good. However, it is important to reduce the costs of care as much
as possible and one possibility is reducing hospital stay. Objective: To assess
wich factors are associated with the time of hospital stay and costs of care in posttransplanted
kidney patients. Material and methods: An observational, crosssectional,
retrospective study was carried out in patients post-operated from kidney
trasplantation at the Centenario Hospital Miguel Hidalgo. Results: 98 posttransplant
kidney patients were included, 56 entered to the General Surgery
service to receive post-operative care and the remaining 42 to the Intermediate
Intensive Care Unit (ICU). Among the patients with post-operative care in the ICU,
the length of stay was 4.0 ± 0.9 days and in those admitted to the post-operative
period in the General Surgery Service, the average hospital stay was 4.2 ± 1.5
days (p= 0.674). While, the overall costs of care in patients admitted to the ICU
were $ 84074.8 ± 13707.8 MXN and among the patients who were treated in the
post-operative period in the General Surgery Service were $ 76329.6 ± 21291.3 (p
= 0.201). After multivariate analysis, among the patients with intraoperative
complications the hospital stay was greater in those who received post-operative
care in the ICU (5.1 ± 2.0 days) than in General Surgery (4.5 ± 2.6 days); and the
total cost of care was $ 88,869.49 in those admitted to the ICU than in those
admitted to general surgery $ 80,292.33. Conclusions: In patients without
intraoperative complications there were no differences in hospital stay or in the
costs of care; but among those with intraoperative complications, those who
received post-operative care in the ICU had a longer hospital stay and higher
average care costs. It is recommended to evaluate the possibility of providing postoperative
care in the General Surgery Service instead of in the Intermediate
Intensive Therapy.
Keywords: Chronic kidney disease, Kidney transplant, Live donor, Postoperative
management.
