Risk factors for prolonged hospitalization after kidney transplants.
Risk factors for prolonged hospitalization after kidney transplants.
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发表时间：
1997-08
影响因子：
2.1
通讯作者：
A. Matas;K. Gillingham;B. Elick;D. Dunn;R. Gruessner;W. Payne;D. Sutherland;J. Najarian
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文献类型：
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作者：
A. Matas;K. Gillingham;B. Elick;D. Dunn;R. Gruessner;W. Payne;D. Sutherland;J. Najarian
肾移植费用的一个主要变量是最初住院的时间。使用多变量分析，我们研究了移植后住院时间> 10 d的风险因素。1985年1月1日至1995年8月31日，共有1588例患者在明尼苏达大学接受了第一次或第二次肾移植。抗体在尸体供体受体中使用1周，在儿科受体中使用2周（导致所有儿科受体的长期停留）。成人活体亲属供受体采用三联疗法进行免疫抑制。研究的供体风险因素包括年龄（50岁）和，-对于尸体受体，保存时间（30小时）和死亡原因（创伤，脑血管意外或心脏）。研究的主要风险因素包括年龄（55岁）、性别、移植次数、抗原错配、PRA峰值、移植时PRA（50）、糖尿病状态、移植前透析（vs.抢先移植）、移植前心脏、外周血管或呼吸系统疾病和移植物功能延迟恢复（DGF）（第一周透析vs.未透析）。分别分析了活体和尸体供体受者的风险因素。对于尸体供体受体，DGF是主要的风险因素（p 50（p 55）年（p = 0.02），移植前呼吸系统疾病（p = 0.005）和移植前透析（p = 0.005）。由于DGF是延长住院时间的主要危险因素，我们随后使用多变量分析研究了DGF的危险因素。对于尸体供体受体，风险因素为受体体重> 90 kg（p = 0.004），保存时间24 h（p = 0.03），移植时PRA> 50（p = 0.03），供体年龄50岁（p = 0.002）。对于活体供者，危险因素是受者年龄> 50岁（p = 0.03）、女性（p = 0.05）、移植前呼吸系统疾病（p = 0.1）、移植前外周血管疾病（p = 0.05）和受者体重> 90 kg（p = 0.1）。从我们的数据中，出现了可能有更长住院时间的受者的概况。与DGF同时或相关的重要变量包括供体和受体年龄、糖尿病、移植前受体体重、移植时PRA、保存时间和移植前呼吸或外周血管疾病。
A major variable in the cost of kidney transplants is the length of initial hospitalization. Using multivariate analysis, we studied risk factors for hospital stay > 10 d post-transplant. Between 1 January 1985 and 31 August 1995 a total of 1588 patients underwent first or second kidney transplants at the University of Minnesota. Antibody was used for 1 wk in cadaver donor recipients and for 2 wk in pediatric recipients (resulting in a long stay for all pediatric recipients). Adult living related donor recipients were immunosuppressed with triple therapy. Donor risk factors studied were age ( 50 yr) and,- for cadaver recipients, preservation time ( 30 h) and cause of death (trauma, cerebrovascular accident, or cardiac). Recipient risk factors studied were age ( 55 yr); sex; transplant number; antigen mismatch; peak PRA; PRA at transplant ( 50); diabetic status; pretransplant dialysis (vs. pre-emptive transplant); pretransplant cardiac, peripheral vascular, or respiratory disease; and delayed graft function (DGF) (dialysis in the first week vs. no dialysis). Risk factors were analyzed separately for living donor and cadaver donor recipients. For cadaver donor recipients, DGF was the major risk factor (p 50 (p 55 yr (p = 0.02), pretransplant respiratory disease (p = 0.005), and pretransplant dialysis (p = 0.005). Because DGF was the major risk factor for a prolonged stay, we then studied risk factors for DGF using multivariate analysis. For cadaver donor recipients, risk factors were recipient weight > 90 kg (p = 0.004), preservation time 24 h (p = 0.03), PRA at transplant > 50 (p = 0.03), and donor age 50 yr (p = 0.002). For living donor recipients, risk factors were recipient age 50 yr (p = 0.03), female sex (p = 0.05), pretransplant respiratory disease (p = 0.1), pretransplant peripheral vascular disease (p = 0.05), and recipient weight > 90 kg (p = 0.1). From our data, a profile emerged of recipients likely to have a longer hospital stay. Important variables, either simultaneous with or related to DGF, include donor and recipient age, diabetes, pretransplant recipient weight, PRA at transplant, preservation time, and pretransplant respiratory or peripheral vascular disease.