PCV30 Incidence of Common Infection and Medical Costs after Heart Transplantation: A Retrospective Observational Analysis from National Inpatient Sample DATA

Abstract

Heart transplantation is the only fundamental treatment for end-stage heart disease. However, infectious complications are easily caused by immunosuppressive therapy used to reduce acute organ rejection. Therefore, we assessed the incidence of common infection and the medical costs of heart transplant recipients. We used data of heart transplant recipients during 2015-2018 from the Korean Health Insurance Review & Assessment Service - National Inpatient Sample (HIRA-NIS). Recipients were followed up until 6 months after transplantation or the last day of each year (31 December), whichever is earlier, and categorized into two groups: recipients with and without common infection requiring hospitalization after heart transplantation. Common infection includes gastrointestinal (GI) tract infection, pneumonia, lower respiratory tract infection (LRTI), stomatitis, urinary tract infection (UTI). We estimated the incidence of a common infection requiring hospitalization, and the median heart transplantation cost and 6 months of median monthly follow-up costs. A total of 61 recipients were identified (37 and 24 recipients, with and without common infection groups, respectively). The incidence of common infection was 3.87 cases per person-year and the highest in LRTI (2.09 cases per person-year). In a group with common infection, the median heart transplantation cost per recipient was $62,446 and, monthly follow-up cost sharply decreased in the first four months ($19,707 to $1,306) and remained the next two months. On the other hand, in a group without common infection, the transplantation cost was $55,706 and, monthly follow-up cost decreased in the first two months ($2,263 to $1,265) and remained the next four months. Infection occurred in multiple sites in each recipient, the most common in the lower respiratory tract. Compared to the group without common infection, the group with common infection had higher costs, especially at heart transplantation cost and monthly follow-up cost of first to third months.