Faculty Collaboration Database

Predictors and impact of thirty-day readmission on patient outcomes and health care costs after reduced-toxicity conditioning allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 2014 Mar;20(3):415-20

Date

12/24/2013

Pubmed ID

24361913

Pubmed Central ID

PMC4557764

DOI

10.1016/j.bbmt.2013.12.559

Scopus ID

2-s2.0-84896859987 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

Thirty-day readmission (30-DR) has become an important quality-of-care measure. Allogeneic hematopoietic cell transplantation (allo-HCT) presents a medical setting with higher readmission rates. We analyzed factors affecting 30-DR and its impact on patient outcomes and on health care costs in 91 patients who underwent reduced-toxicity conditioning (RTC) allo-HCT with fludarabine and busulfan. The patient cohort was divided into 2: the readmission group (R-gp) or the no-readmission group (NR-gp). Overall, 38% (n = 35) required readmission with a median time to readmission of 14 days. In multivariate analysis, only documented infection during the index admission predicted 30-DR, P = .01. With a median follow-up of 18 months (range, 1 to 69) for surviving patients, the 2-year overall survival was 49% and 58% in the R-gp and NR-gp respectively, P = .48. The 1-year nonrelapse mortality in R-gp and NR-gp was 18% and 13% respectively, P = .43. The median post-transplantation hospital charges in the R-gp and NR-gp were $85,115 (range, $32,015 to $242,519) and $45,083 (range, $10,715 to $485,456), P = .0002. In conclusion, only documented infections during the index hospitalization influenced 30-DR after RTC allo-HCT. Although 30-DR did not adversely affect mortality or survival, it was associated with significantly increased 100-day post-transplantation hospital charges, thus supporting its role as a quality-of-care measure in allo-HCT patients.

Author List

Rauenzahn S, Truong Q, Cumpston A, Goff L, Leadmon S, Evans K, Zhang J, Wen S, Craig M, Hamadani M, Kanate AS

Author

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Aged
Busulfan
Cross Infection
Female
Graft vs Host Disease
Health Care Costs
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Myeloablative Agonists
Patient Readmission
Survival Analysis
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Vidarabine