Moghani Lankarani Maryam, Noorbala Mohammad Hossein, Assari Shervin
Clinical Research Unit, Baqiyatallah Medical Sciences University, Tehran, Iran.
Ann Transplant. 2009 Oct-Dec;14(4):14-9.
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.
MATERIAL/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.
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.
Early post-kidney transplantation phase, with a higher risk of infections and surgical complications, health care system experience longer and more costly hospitalizations.
肾移植后的再次入院受到关注，因为其成本高昂且会导致发病，或者可能以不理想的结局告终，即移植肾丢失或死亡。我们比较了肾移植后不同时期再次入院的模式、结局和成本。
材料/方法：在一项回顾性研究中，对562例肾移植受者的连续再次入院情况进行分类，分为早期（前6个月内；n = 278）、中期（6 - 24个月；n = 115）和晚期（24个月及以后；n = 169）住院。主要结局指标包括住院模式（住院原因和住院时间），次要结局指标评估（住院期间的死亡率和移植肾丢失）以及成本。
再次住院的原因在早期为手术并发症（84%）、感染（51%）、移植肾排斥（45%）和恶性肿瘤（0.6%）；中期为移植肾排斥（44%）、感染（42%）、手术并发症（13%）和恶性肿瘤（5%）；晚期为移植肾排斥（45%）、感染（39%）、手术并发症（3%）和恶性肿瘤（0.06%）。因此，感染和手术并发症从移植后早期到晚期呈下降趋势，而恶性肿瘤在中期出现高峰。移植后早期的住院时间（12±11、10±10、9±7，p = 0.001）和住院费用（708±36、468±333、413±262美元，p = 0.035）显著更高。所有时间段的死亡率（p = 0.755）和住院期间的移植肾丢失率（p = 0.246）保持不变。
肾移植后早期感染和手术并发症风险较高，医疗系统经历的住院时间更长且成本更高。
