Cytomegalovirus disease is associated with increased cost and hospital length of stay among orthotopic liver transplant recipients.
Cytomegalovirus disease is associated with increased cost and hospital length of stay among orthotopic liver transplant recipients.
复制标题
巨细胞病毒病与原位肝移植受者的费用和住院时间增加有关。
DOI：
10.1097/00007890-199706150-00010
复制
发表时间：
1997
期刊：
影响因子：
6.2
通讯作者：
Snydman,DR
中科院分区：
文献类型：
--
作者：
Falagas,ME;Arbo,M;Ruthazer,R;Griffith,JL;Werner,BG;Rohrer,R;Freeman,R;Lewis,WD;Snydman,DR
巨细胞病毒（CMV）是引起原位肝移植（OLT）受者相当高的发病率和死亡率的原因。为了研究巨细胞病毒对这一人群的费用和住院时间的影响，我们对波士顿四个移植中心参加巨细胞病毒预防试验的OLT受者队列进行了分析。纳入研究的所有141例患者移植后第一年住院时间（包括移植后住院时间和移植后1年内再入院时间）均可获得。在多元线性回归模型中，菌血症（P= 0.0001）、CMV疾病（P= 0.0007）、腹部再检查（不包括再移植）（P= 0.0070）、受体年龄≤16岁（P= 0.0352）和移植期间给予的血液制品（红细胞、血小板或新鲜冷冻血浆）单位数（P= 0.0523）被证明与移植后第一年住院时间较长独立相关。66例肝移植受者入院后一年的住院护理费用数据。使用多元线性回归模型，CMV疾病的发展（P= 0.0001）、移植期间使用的血液制品单位数（P= 0.0001）、菌血症（P= 0.0002）、移植前肾功能下降（通过肌酐清除率估计）（P= 0.0109）和再次移植需求（P= 0.0619）被证明与较高的成本独立相关。这些数据强烈表明，巨细胞病毒疾病对肝移植的费用和住院时间有直接影响。
Cytomegalovirus (CMV) is a cause of considerable morbidity and mortality among orthotopic liver transplant (OLT) recipients. To study the impact of CMV on cost and hospital length of stay in this population, we undertook an analysis of a cohort of OLT recipients from four transplant centers in Boston who participated in a CMV prophylaxis trial. First posttransplant year hospital length of stay (including the hospital stay after transplantation and readmissions within 1 year after transplantation) was available for all 141 patients included in the study. In a multiple linear regression model, bacteremia (P= 0.0001), CMV disease (P= 0.0007), abdominal reexploration (excluding retransplantation)(P= 0.0070), recipient age≤ 16 years (P= 0.0352), and the number of units of blood products (red blood cells, platelets, or fresh frozen plasma) administered during transplantation (P= 0.0523) were shown to be independently associated with longer first posttransplant year hospital length of stay. Cost data for in-hospital care for the year beginning with admission for liver transplantation were available for 66 OLT recipients. Using a multiple linear regression model, development of CMV disease (P= 0.0001), the number of units of blood products administered during transplantation (P= 0.0001), bacteremia (P= 0.0002), decreased pretransplant renal function (estimated by creatinine clearance)(P= 0.0109), and need for retransplantation (P= 0.0619) were shown to be independently associated with higher cost. These data strongly suggest that CMV disease has a direct impact on cost and hospital length of stay in liver transplantation.