BACKGROUND: Patient problems after heart transplant (HT) can lead to rehospitalization. OBJECTIVE: To examine rehospitalization patterns and identify predictors of the number of days rehospitalized at the transplant site during the first year after HT surgery. METHODS: Hierarchical regression identified predictors of greater rehospitalization time from chart data collected from two transplant sites during the first posttransplant year on 269 adult HT recipients. Variables (total = 32) were entered in six steps: clinical site, demographics, perioperative variables, cardiac function, immunosuppressant dosages, and post-HT complications. RESULTS: The number of days rehospitalized at the transplant site during the first year after HT ranged from 0 to 142 (mean = 25, median = 16); 64% were rehospitalized; 37% were rehospitalized more than once. Main reasons were rejections, infections, cardiovascular problems, and gastrointestinal (GI) problems. The regression model explained 48.7% of the variance in rehospitalization time, with post-HT complications explaining the most variance. Ten predictors were significant: intravenously treated infections, treated acute rejections, shorter stay for HT surgery, GI complications, higher prednisone dose, female gender, coma, sex mismatch between donor and recipient, renal complications, and clinical site. CONCLUSION: Sixty-four percent of the patients were rehospitalized at the transplant site during the first year after HT surgery (with a median of 16 hospital days); 37% were rehospitalized more than once. Significant predictors of the amount of time rehospitalized pertained to five types of complications (rejections, infections, GI, renal, coma), shorter HT surgical stay, female gender, higher prednisone dose, sex-mismatched donor, and clinical site. The study identifies who uses the most hospital resources during the first year after HT.
BACKGROUND:Patient problems after heart transplant (HT) can lead to rehospitalization. OBJECTIVE: To examine rehospitalization patterns and identify predictors of the number of days rehospitalized at the transplant site during the first year after HT surgery. METHODS: Hierarchical regression identified predictors of greater rehospitalization time from chart data collected from two transplant sites during the first posttransplant year on 269 adult HT recipients. Variables (total = 32) were entered in six steps: clinical site, demographics, perioperative variables, cardiac function, immunosuppressant dosages, and post-HT complications. RESULTS: The number of days rehospitalized at the transplant site during the first year after HT ranged from 0 to 142 (mean = 25, median = 16); 64% were rehospitalized; 37% were rehospitalized more than once. Main reasons were rejections, infections, cardiovascular problems, and gastrointestinal (GI) problems. The regression model explained 48.7% of the variance in rehospitalization time, with post-HT complications explaining the most variance. Ten predictors were significant: intravenously treated infections, treated acute rejections, shorter stay for HT surgery, GI complications, higher prednisone dose, female gender, coma, sex mismatch between donor and recipient, renal complications, and clinical site. CONCLUSION: Sixty-four percent of the patients were rehospitalized at the transplant site during the first year after HT surgery (with a median of 16 hospital days); 37% were rehospitalized more than once. Significant predictors of the amount of time rehospitalized pertained to five types of complications (rejections, infections, GI, renal, coma), shorter HT surgical stay, female gender, higher prednisone dose, sex-mismatched donor, and clinical site. The study identifies who uses the most hospital resources during the first year after HT.
Authors: Nobuyuki Shiba; Michael C Y Chan; Hannah A Valantine; Shao-Zhou Gao; Robert C Robbins; Sharon A Hunt Journal: J Heart Lung Transplant Date: 2003-10 Impact factor: 10.247
Authors: David O Taylor; Leah B Edwards; Mark M Boucek; Elbert P Trulock; Berkeley M Keck; Marshall I Hertz Journal: J Heart Lung Transplant Date: 2004-07 Impact factor: 10.247
Authors: Dipin Gupta; Valentino Piacentino; Mahender Macha; Arun K Singhal; John P Gaughan; James B McClurken; Bruce I Goldman; Carol A Fisher; Dan Beltramo; John Monacchio; Howard J Eisen; Satoshi Furukawa Journal: Ann Thorac Surg Date: 2004-09 Impact factor: 4.330
Authors: Jacqueline M A Smits; Johan Vanhaecke; Axel Haverich; Erwin de Vries; Mike Smith; Ellis Rutgrink; Annemarie Ramsoebhag; Alinde Hop; Guido Persijn; Gunther Laufer Journal: Clin Transpl Date: 2003
Authors: L D Sharples; N Caine; P Mullins; J P Scott; E Solis; T A English; S R Large; P M Schofield; J Wallwork Journal: Transplantation Date: 1991-08 Impact factor: 4.939
Authors: A Nicole Lambert; Jeffrey G Weiner; Matt Hall; Cary Thurm; Debra A Dodd; David W Bearl; Jonathan H Soslow; Brian Feingold; Andrew H Smith; Justin Godown Journal: Pediatr Cardiol Date: 2020-02-26 Impact factor: 1.655
Authors: René M'Pembele; Sebastian Roth; Alexandra Stroda; Giovanna Lurati Buse; Stephan U Sixt; Ralf Westenfeld; Amin Polzin; Philipp Rellecke; Igor Tudorache; Markus W Hollmann; Hug Aubin; Payam Akhyari; Artur Lichtenberg; Ragnar Huhn; Udo Boeken Journal: ESC Heart Fail Date: 2021-11-04