Predictors of rehospitalization time during the first year after heart transplant
Predictors of rehospitalization time during the first year after heart transplant
复制标题
DOI：
10.1016/j.hrtlng.2007.10.007
复制
发表时间：
2008-09-01
期刊：
影响因子：
2.8
通讯作者：
White-Williams, Connie
中科院分区：
文献类型：
--
作者：
Jalowiec, Anne;Grady, Kathleen L.;White-Williams, Connie
背景技术背景：心脏移植（HT）后的患者问题可能会导致rehospitalization.Objective：研究再住院模式，并确定在移植部位再住院的粘土数量的预测因素，在第一年后HT surgery.METHODS：分层回归确定更大reliospitalization时间的预测因素，从图表收集的数据从两个移植部位在移植后的第一年269名成人HT收件人。变量（共= 32）进入六个步骤：临床部位，人口统计学，围手术期变量，心脏功能，免疫抑制剂剂量，和后HT complications.Results：在移植部位再住院的天数在HT后的第一年范围从0到142（平均值= 25，中位数= 16）; 64%再住院; 37%再住院超过一次。主要原因是排斥反应、感染、心血管问题和胃肠道（GI）问题。回归模型的解释率为48.7%。再住院时间的差异，HT后并发症解释了最大的差异。10个预测因子具有显著性：静脉内治疗感染，治疗急性排斥反应，HT手术的住院时间较短，GI并发症，较高的泼尼松剂量，女性性别，昏迷，供体和受体之间的性别不匹配，肾脏并发症和临床部位。结论：64%的患者在HT手术后的第一年内在移植部位再次住院（中位住院日为16天）; 37%的患者再次住院超过一次。再住院时间的重要预测因素涉及五种类型的并发症（排斥反应、感染、GI、肾脏、昏迷）、HIT手术时间较短、女性、泼尼松剂量较高、性别不匹配的供体和临床部位。这项研究确定了HT后第一年谁使用了最多的医院资源。
BACKGROUND: Patient problems after heart transplant (HT) can lead to rehospitalization.OBJECTIVE: To examine rehospitalization patterns and identify predictors of the number of clays rehospitalized at the transplant site during the first year after HT surgery.METHODS: Hierarchical regression identified predictors of greater reliospitalization 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 rehospitatized 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.CONCLUSION: 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 HIT 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.