title: Early hospital readmission was less likely for hemodialysis patients from facilities with longer median length of stay in the DOPPS study.
abstract: The length of hospital stay is considered to influence hospital readmission in general. The Dialysis Outcomes and Practice Patterns Study (DOPPS), an international prospective observational study undertaken to establish a relationship between facility practices and dialysis outcomes, started in 1996. Results suggest that the duration of hospital stay is significantly correlated with the probability of early readmission in dialysis patients. Thus, early hospital readmission was observed to be less likely for hemodialysis patients from facilities with longer median length of stay. The lengths of hospital stay for hemodialysis patients differed in the three continents studied. Although socioeconomic pressures may drive the lengths of hospital stay, the duration of hospitalization should be determined keeping in mind the safety of clinical course for each disease. In this forum, a 47-year-old female hemodialysis patient with severe secondary hyperparathyroidism, who had been treated with hemodialysis for 21 years, was hospitalized with severe clinical symptoms. Although the clinical symptoms disappeared 10 days after total parathyroidectomy with autotransplantation, severe hypocalcemia persisted despite large amounts of intravenous calcium gluconate. This patient was hospitalized for a long duration owing to the large calcium deficit in her body. Had the length of her hospital stay been shortened, either she could have needed rehospitalization or her condition could have worsened.
authors.affiliation: Division of Nephrology, Department of Medicine, Institute of Medical Science, Tokai University, Bohseidai, Isehara, Kanagawa 259-1193, Japan. asait@is.icc.u-tokai.ac.jp
authors.forename: Futoshi
authors.initials: F
authors.lastname: Tadaki
authors.forename: Miho
authors.initials: M
authors.lastname: Inagaki
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Shin-Iti
authors.initials: SI
authors.lastname: Tanaka
authors.forename: Reika
authors.initials: R
authors.lastname: Tanaka
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kakuta
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
mesh_terms: D002125:Calcium Gluconate / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000191:economics / Q000209:etiology / Q000628:therapy*; D006996:Hypocalcemia / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D007902:Length of Stay / Q000191:economics; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics; D006435:Renal Dialysis / Q000191:economics; D016896:Treatment Outcome
chemical_list: D002125:Calcium Gluconate