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International Journal of Hematology

, Volume 108, Issue 3, pp 290–297 | Cite as

Impact of hospital length of stay on the risk of readmission and overall survival after allogeneic stem cell transplantation

  • Aika Seto
  • Yoshiko Atsuta
  • Naomi Kawashima
  • Yukiyasu Ozawa
  • Koichi Miyamura
  • Hitoshi Kiyoi
Original Article

Abstract

Patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at high risk of readmission for complications. We sought to examine the association between HSCT hospital length of stay and the incidence of readmission and survival after discharge. We retrospectively reviewed the cases of 230 allo-HSCT recipients. The cumulative incidence of readmission with non-relapse transplant-related complications (including infections; acute and chronic GVHD; liver, lung, renal, or neurological complications; and haematological abnormalities) 2 years after the first discharge was 49.7% in patients with length of stay ≤ 100 days (n = 156), and 66.6% in patients with length of stay > 100 days (n = 74) (P = 0.02). The cumulative incidence of readmission with infections 2 years after first discharge was lower in the length of stay ≤ 100 days group than in the length of stay > 100 days patients (27.1 vs. 41.3%, P = 0.04). Length of stay > 100 days was the only risk factor identified that correlated positively with the rate of readmission for non-relapse transplant-related complications [relative risk (RR) 1.53; 95% confidence interval (CI) 1.08–2.18, P = 0.018] or infections [RR 1.64; CI 1.03–2.61; P = 0.038]. Close follow-up of patients with longer length of stay after allo-HSCT is advised.

Keywords

Allogeneic stem cell transplantation Risk factors Length of stay Readmission 

Notes

Acknowledgements

The authors would like to thank Mizuho Takeda and Aiko Fujiwara for their assistance with data management.

Author contributions

AS, YA, KM, and HK designed the study, and wrote the paper; AS and YA analysed the results and made the figures; YO and NK submitted and cleaned the data and reviewed the results.

Compliance wih ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. A summary of relevant information will be published with the manuscript.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  1. 1.Department of Hematology and OncologyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Japanese Data Center for Hematopoietic Cell TransplantationNagoyaJapan
  4. 4.Department of HematologyJapanese Red Cross Nagoya First HospitalNagoyaJapan

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