Variables Clínicas y Operacionales Asociadas a los Costos Hospitalarios en el Período Posoperatorio del Trasplante Hepático: Revisión de Alcance
Palavras-chave:
Transplante de Fígado, Custos e Análise de Custo, Período Pós-Operatório, Administração de Serviços de SaúdeResumo
No período pós-operatório do transplante hepático, a ocorrência de complicações e a intensa utilização de recursos hospitalares podem impactar significativamente as despesas relacionadas ao cuidado dos pacientes. Os objetivos deste estudo foram mapear as evidências disponíveis na literatura sobre os custos hospitalares associados ao transplante hepático no período pós-operatório e identificar as variáveis clínicas e operacionais relacionadas a esse desfecho. Trata-se de revisão de escopo conduzida de acordo com a metodologia do Joanna Briggs Institute e as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). As buscas foram realizadas nas bases PubMed/MEDLINE, Embase, Web of Science e Biblioteca Virtual em Saúde, sem restrição temporal. Foram incluídos estudos originais que apresentassem análise de custos hospitalares e identificassem variáveis do receptor, do doador ou do procedimento associadas ao consumo de recursos no período pós-operatório do transplante hepático. Foram incluídas 11 coortes retrospectivas, um estudo de avaliação econômica, um ensaio clínico randomizado e uma série de casos. Entre os preditores clínicos de maior custo, destacaram-se escore Model for End-Stage Liver Disease (MELD) elevado, insuficiência renal pré-operatória e baixa capacidade funcional. Entre as variáveis operacionais, destacaram-se o tempo prolongado de isquemia fria, a maior duração da cirurgia e o volume de transfusão de hemocomponentes. Complicações pós-operatórias, como infecções do sítio cirúrgico, reoperações e readmissões hospitalares, também contribuíram para o aumento das despesas, sendo a permanência em unidade de terapia intensiva o principal componente do custo hospitalar. Concluiu-se que variáveis clínicas e operacionais influenciam os custos hospitalares após o transplante hepático. A identificação e mitigação de fatores potencialmente modificáveis podem contribuir para a maior eficiência na utilização de recursos e para a sustentabilidade econômica dos programas de transplante.
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Copyright (c) 2026 Deyvid Fernando Mattei da Silva, Laís Maria de Campos, Otávio Monteiro Becker Junior, Janine Schirmer, Bartira de Aguiar Roza
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
