Predictors of rehospitalization time during the first year after heart transplant.
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.


CONCLUSIONS
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.
Jalowiec
Anne
A
Loyola University, Chicago, IL, USA. ajalowiec@yahoo.com
Grady
Kathleen L
KL
White-Williams
Connie
C
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003128:Coma / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D017678:Sex Distribution; D012737:Sex Factors
D011241:Prednisone
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