In-Hospital Mortality Following Organ Transplantation

The proportion of organ transplant recipients who die during the hospital stay in which they receive their transplant

Lower proportions are desirable.

Data updated:
Data availability: to (calendar years)
Geographic coverage
All provinces/territories
Reporting level
National, Province/Territory
Calculation

Proportion = Number of hospitalizations for organ transplant where the discharge reason was death ÷ Number of hospitalizations where a kidney, liver, heart or lung transplantation occurred

Unit of analysis: Hospitalization

Denominator

Number of hospitalizations where a kidney, liver, heart or lung transplantation occurred

Numerator

Number of hospitalizations for organ transplant where the discharge reason was death

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Sources

Canadian Organ Replacement Register and Hospital Morbidity Database, Canadian Institute for Health Information.

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Notes

Certain metric values were suppressed or modified for confidentiality reasons in accordance with CIHI’s privacy policy. These values are identified with the text “Suppressed” in the data tables and hover-over tool tip.

The dash (—) indicates that no data is available. Select different parameters or reset the chart.

Sources

Canadian Organ Replacement Register and Hospital Morbidity Database, Canadian Institute for Health Information.

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Name

In-Hospital Mortality Following Organ Transplantation

Short/Other Names

Not applicable

Description

The proportion of organ transplant recipients who die during the hospital stay in which they receive their transplant

Rationale

Death following organ transplantation is an important complication of transplantation surgery. Understanding variation in in-hospital mortality following organ transplantation can help identify populations at higher risk of death, as well as care practices that affect this risk.

Interpretation

Lower proportions are desirable.

HSP Framework Dimension

Appropriate and effective

Targets/Benchmarks

Not applicable

Available Data Years

to

Geographic Coverage

  • All provinces/territories

Reporting Level/Disaggregation

  • National
  • Province/Territory
  • Age
  • Sex 
  • Neighbourhood income quintile of patient residence
  • Organ

Indicator Results

Not applicable

Update Frequency

Every year

Latest Results Update Date

Updates

Not applicable

Description

Proportion = Number of hospitalizations for organ transplant where the discharge reason was death ÷ Number of hospitalizations where a kidney, liver, heart or lung transplantation occurred

Unit of analysis: Hospitalization

Type of Measurement

Percentage or proportion

Denominator

Description:

Number of hospitalizations where a kidney, liver, heart or lung transplantation occurred

Inclusions:

  1. Age 18 or older 
  2. The first transplantation intervention in the hospitalization was for a kidney, liver, heart or lung

Hospitalization data is from the Hospital Morbidity Database (HMDB) and is supplemented with data from the Canadian Organ Replacement Register (CORR) as follows:

  1. Organ transplants in the HMDB have code 1.GR.85.^^, 1.GT.85.^^, 1.HY.85.^^, 1.HZ.85.^^, 1.NK.85.^^, 1.NP.85.^^, 1.OA.85.^^, 1.OJ.85.^^, 1.OK.85.^^ or 1.PC.85.^^. Only those where the status attribute code is not A (abandoned) are considered.
  2. Transplantation episodes are linked to CORR data using the patient’s health card number and surgery date (plus or minus 1 day). In the case of duplicate linkages, the best match is chosen using the following priorities:
    1. If available, choose the record where the CORR surgery date matches the HMDB episode start date.
    2. Otherwise, choose the record where the CORR surgery date matches the HMDB episode end date.
    3. Otherwise, choose the record with the lowest CORR recipient treatment ID.
  3. If a CORR record links, information on organs transplanted comes from CORR. Otherwise, information comes from the HMDB.

Transplanted organs are defined as the following:

  1. Kidney: CORR organ type code beginning with 1; HMDB CCI code 1.PC.85.^^
  2. Liver: CORR organ type code beginning with 2; HMDB CCI code 1.OA.85.^^
  3. Heart: CORR organ type code 30; HMDB CCI code 1.HZ.85.^^
  4. Lung: CORR organ type code beginning with 4; HMDB CCI code 1.GR.85.^^ or 1.GT.85.^^

Exclusions:

  1. Discharge due to medical assistance in dying (discharge disposition code 73)
  2. The first transplantation procedure in the hospitalization was an organ retransplantation:
    1. CORR: Graft number is greater than 1
    2. HMDB: A previous transplantation of the same organ had occurred in the same patient since 2013
  3. The first transplantation procedure in the hospitalization involved transplantation of several organ types, defined as either
    1. CORR: Records for multiple organ types for 1 surgery, or organ type code 43 or 90
    2. HMDB: Multiple codes for organ transplants (as defined in the inclusion criteria) in the same surgical episode
  4. Invalid health card number or code for province issuing health card number 

Numerator

Description:

Number of hospitalizations for organ transplant where the discharge reason was death

Inclusions:

Included in the numerator and discharge disposition coded as 07, 66, 67, 71, 72 or 74

Exclusions:

Not applicable

Geographic Assignment

Place of service

Data Sources

  • CORR
  • HMDB

Caveats and Limitations

In-hospital mortality data is available only from the HMDB. Therefore, the number of organ transplants reported by this indicator may not match the number in products where CORR is the primary data source.
The HMDB does not code retransplant status. For records where the HMDB transplant record does not link to CORR, the status of a transplant as a first transplant is derived through longitudinal linkage. If a patient had a previous transplant before 2014, with a different health care number or — for Quebec and Manitoba — in a different province, their retransplant may be erroneously classified as a first transplant. This has the biggest impact for Quebec data, where data from CORR is not available.

Trending Issues

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Comments

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References

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