肾移植后再次住院的原因；受者年龄有影响吗？

Causes of rehospitalization after renal transplantation; does age of recipient matter?

作者信息

Nemati E, Saadat A-R, Hashemi M, Khoddami-Vishteh H-R, Moghani-Lankarani M

机构信息

Nephrology and Urology Research Center, Baqiyatallah Medical Center, Baqiyatallah Medical Sciences University, Tehran, Iran.

出版信息

Transplant Proc. 2007 May;39(4):970-3. doi: 10.1016/j.transproceed.2007.03.078.

DOI:10.1016/j.transproceed.2007.03.078

PMID:17524865

Abstract

BACKGROUND

This study assessed the causes and related factors of rehospitalization following renal transplantation among elderly compared with younger patients.

METHODS

We reviewed the charts of 567 patients rehospitalized after kidney transplantation from 2000 to 2006. According to age at the time of transplantation, hospitalizations were divided into two groups: group 1 (age >or=50 years) and group II (age 20 to 50 years). Demographics, clinical findings, causes for rehospitalization, patient outcomes (recovery, graft loss, death), intensive care unit (ICU) admission, length of hospital stay, time interval from transplantation to rehospitalization, as well as hospital costs were compared between the two groups.

RESULTS

One hundred eighty-five (32.6%) rehospitalizations were charted for group I, who showed a higher proportion of admissions due to infection (42.2% vs 29.8%, P=.004) and macrovascular disease (3.8% vs 1.0%, P=.027) compared with group II. ICU admission (8.8% vs 2.4%, P=.001), mortality (10.2% vs 3.6%, P=.008), and hospital charges (1610 +/- 933 vs 931 +/- 850 purchase power parity dollars, P=.001) were also seen more frequently in group I but displayed a lower frequency of admissions due to graft rejection (20% vs 34.3%, P=.001).

CONCLUSION

Recipient age at the time of transplantation was a main factor affecting rehospitalization among our patients.

摘要

背景

本研究评估了老年肾移植患者与年轻患者相比再次住院的原因及相关因素。

方法

我们回顾了2000年至2006年间567例肾移植后再次住院患者的病历。根据移植时的年龄，将住院患者分为两组：第1组（年龄≥50岁）和第2组（年龄20至50岁）。比较了两组患者的人口统计学、临床特征、再次住院原因、患者预后（康复、移植肾丢失、死亡）、重症监护病房（ICU）入住情况、住院时间、从移植到再次住院的时间间隔以及住院费用。

结果

第1组记录了185例（32.6%）再次住院患者，与第2组相比，该组因感染（42.2%对29.8%，P = 0.004）和大血管疾病（3.8%对1.0%，P = 0.027）导致的入院比例更高。第1组的ICU入住率（8.8%对2.4%，P = 0.001）、死亡率（10.2%对3.6%，P = 0.008）和住院费用（1610±933对931±850购买力平价美元，P = 0.001）也更常见，但因移植肾排斥导致的入院频率较低（20%对34.3%，P = 0.001）。