Faculty Collaboration Database

Psychosocial risk predicts high readmission rates for hematopoietic cell transplant recipients. Bone Marrow Transplant 2018 Nov;53(11):1418-1427

Date

02/16/2018

Pubmed ID

29445123

Pubmed Central ID

PMC6092254

DOI

10.1038/s41409-018-0118-4

Scopus ID

2-s2.0-85042124051 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

Hematopoietic cell transplantation (HCT) is an intensive treatment resulting in disease control however subsequent psychosocial distress is common. Screening for psychosocial risk factors that contribute to morbidity is underutilized; moreover, the value in screening is uncertain. We performed a retrospective study of 395 HCT patients who were screened for psychosocial risk using the Transplant Evaluation Rating Scale (TERS). Patients were classified by psychosocial risk as no-risk (TERS = 26.5, 52%) vs. at-risk (TERS > 26.5, 48%), with at-risk patients stratified by cumulative deficits into mild risk (TERS = 27-35.5, 39%) and moderate risk (TERS > 35.5, 9%). At-risk patients were more likely to be readmitted within 90 days (mild risk HR = 1.62, p = 0.02; moderate risk HR = 2.50, p = 0.002). Prior psychiatric history (HR = 1.81, p = 0.002) and poor coping skills (HR = 1.64, p = 0.04) also influenced readmission. At-risk patients were more likely to be readmitted for infection (no-risk = 12% vs. at-risk = 25%, p = 0.002). Pre-HCT screening with the TERS did not predict survival or length of stay although at-risk patients are at a heighted risk of readmission. Implementing strategies to reduce readmission in higher risk patients is warranted.

Author List

Richardson DR, Huang Y, McGinty HL, Elder P, Newlin J, Kirkendall C, Andritsos L, Benson D, Blum W, Efebera Y, Penza S, Hofmeister C, Jaglowski S, Klisovic R, Vasu S, William B, Devine S, Rosko AE

Author

Samantha M. Jaglowski MD, MPH Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Patient Readmission
Retrospective Studies
Risk Factors
Transplantation Conditioning
Young Adult