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

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.

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Acknowledgements

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

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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.

Corresponding author

Correspondence to Aika Seto.

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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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Seto, A., Atsuta, Y., Kawashima, N. et al. Impact of hospital length of stay on the risk of readmission and overall survival after allogeneic stem cell transplantation. Int J Hematol 108, 290–297 (2018). https://doi.org/10.1007/s12185-018-2477-4

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Keywords

  • Allogeneic stem cell transplantation
  • Risk factors
  • Length of stay
  • Readmission