Postlung transplant rehospitalization: a study of causes, health care burden, and outcomes.
OBJECTIVE
Rehospitalization is a significant burden for transplant systems, which use data on hospitalization to monitor practice outcomes. In this study, all rehospitalizations after successful lung transplant performed in our medical center during an 8-year period were assessed for cause, health care resource use, cost, and outcome.


METHODS
We performed a retrospective chart review of all rehospitalizations of lung transplant recipients in Masih Daneshvari Hospital in Darabad, Tehran, between 2000 and 2008. Baseline data (each patient's age at transplant and rehospitalization, sex, primary lung disease, medications used), cause of rehospitalization (infection, graft rejection, surgical complications, type of infection), health care resources use (length of hospital stay, intensive care unit stay, physician visits, imaging), rehospitalization costs (accommodations, personnel, drugs, paraclinical [ie, laboratory] tests, supplies, procedures) and outcome (death, survival) were noted.


RESULTS
In 69% of patients who were rehospitalized after having received a lung transplant, the cause was infection. Other causes were acute rejection in 31% and surgical complications in 6.9%. In 10.3% of those patients, the primary cause for rehospitalization could not be specified. The mean (SD) duration of rehospitalization was 12.8 -/+ 10.4 days. Treatment in the intensive care unit was necessary for 93.1% of the study subjects. The mean (SD) number of physician visits was 27.8 -/+ 27.7, and the fatality rate in the patients studied was 13.8%.


CONCLUSIONS
These data may guide the monitoring of the causes, burden, and outcomes of lung transplants performed in our medical center in Iran and in other medical centers.
Dezfouli
Azizollah Abbasi
AA
Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease, Shaheed Beheshti Medical University, Tehran, Iran.
Najafizadeh
Katayoun
K
Parsa
Tahereh
T
Shadmehr
Mohammad Behgam
MB
Dabir
Shideh
S
Mohammadi
Foruzan
F
Tabarsi
Payam
P
Lankarani
Maryam Moghani
MM
Assari
Shervin
S
Marjani
Majid
M
Fahimi
Fanak
F
Shafaghi
Shadi
S
Faeghi
Jamileh
J
Masjedi
Mohammad Reza
MR
D000328:Adult; D003141:Communicable Diseases / Q000191:economics / Q000209:etiology / Q000628:therapy*; D003422:Critical Care / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005260:Female; D006084:Graft Rejection / Q000191:economics / Q000209:etiology / Q000628:therapy*; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007492:Iran; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects* / Q000191:economics; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000191:economics; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome