Evaluation of readmissions in hematopoietic stem cell transplant recipients.

Abstract Background There is a lack of information on health expenses caused by readmissions among hematopoietic stem cell transplant (HSCT) recipients. We analyzed the rate, causes, and evolution of hospitalization after HSCT. Methods We retrospectively studied 140 consecutive patients who received an autologous HSCT ( n = 107; 76.4%) or an allogeneic HSCT ( n = 33; 23.6%) in our institution from May 2001 through September 2004. Results There were 45 readmissions in 28 patients (20%): three (10%) in the autologous and 25 (90%), in the allogeneic HSCT cohorts. The overall median age was 35.3 ± 13.5 years and 54% were women. Hematologic diseases were: multiple myeloma ( n = 1, 4%), myelodysplastic syndrome ( n = 2, 7%), acute lymphoblastic leukemia ( n = 2, 7%), aplastic anemia ( n = 2, 7%), chronic myeloid leukemia ( n = 3, 11%), non-Hodgkin’s lymphoma ( n = 4, 14%), Hodgkin’s disease ( n = 4, 14%) and acute nonlymphoblastic leukemia ( n = 10, 38%). The length of stay for each readmission was 25 ± 21 days. The median day of readmission was +62.5 (range = +19 to +987); however, 75% occurred between days +30 and +70. The causes of hospitalization were: infections ( n = 24, 54%), due to the graft ( n = 14, 31%), graft failure ( n = 4, 9%), coagulation disorders ( n = 2, 4%), and second neoplasm ( n = 1, 2%). Mortality due to the transplant was 10 patients (14%) including: graft-versus-host disease ( n = 3), sepsis ( n = 3), thrombotic thrombocytopenic purpura ( n = 1), and relapse ( n = 3). Conclusions Although there was a frequent use of hospital resources (20%) after HSCT with patients hospitalized for a median of 25 days, it was beneficial since there were 86% survivors at 36 months follow-up.