Causes of re-hospitalization in different post kidney transplantation periods.
BACKGROUND
Post kidney transplantation Re-admissions are focused because they are costly and cause morbidity, or may end with unsatisfactory endpoints namely graft loss or death. We compared the pattern, outcome and cost of re-admissions in different post-kidney transplantation periods.


METHODS
In a retrospective study, 562 consecutive re-admissions of kidney recipients categorized to early (during first 6 months; n=278); intermediate (6-24 months; n=115); and late (24 months and afterwards, n=169) hospitalizations. Primary outcome measures included hospitalization pattern (cause and length of hospital stay), and secondary outcome measure were assessed (mortality and graft loss during hospitalization) and costs.


RESULTS
The causes of rehospitalization were surgical complication (84 percent), infection (51 percent), graft rejection (45 percent), and malignancy (0.6 percent), in early phase, graft rejection (44 percent), infection (42 percent), surgical complication (13 percent), and malignancy (5 percent), in intermediate phase, and graft rejection (45 percent), infection (39 percent), surgical complication (3 percent), and malignancy (0.06 percent), in late phase. So, infections and surgical complications showed a decreasing trend from early to late post transplant phase, while malignancies showed a peak in intermediate phase. The length of hospital stay (12+/-11, 10+/-10, 9+/-7, p=0.001) and hospitalization charges (708+/-36, 468+/-333, 413+/-262 united states Dollars, p=0.035) were significantly higher in the early post transplant phase. Mortality (p=0.755) and graft loss during hospitalization (p=0.246) remained the same in all time intervals.


CONCLUSIONS
Early post-kidney transplantation phase, with a higher risk of infections and surgical complications, health care system experience longer and more costly hospitalizations.
Moghani Lankarani
Maryam
M
Clinical Research Unit, Baqiyatallah Medical Sciences University, Tehran, Iran. cru_common@yahoo.com
Noorbala
Mohammad Hossein
MH
Assari
Shervin
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006084:Graft Rejection / Q000191:economics / Q000628:therapy*; D006801:Humans; D007239:Infections / Q000191:economics / Q000209:etiology* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome