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High readmission rates are associated with a significant economic burden and poor outcome in patients with grade III / IV acute G v HD
Author(s) -
Dignan Fiona L.,
Potter Mike N.,
Ethell Mark E.,
Taylor Matthew,
Lewis Lily,
Brennan Joy,
McNamara Louise,
Evans Steve O.,
Riley Unell,
Davies Faith E.,
Dearden Claire E.,
Morgan Gareth J.,
Shaw Bronwen E.
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12065
Subject(s) - medicine , graft versus host disease , retrospective cohort study , hematopoietic stem cell transplantation , complication , transplantation , gastroenterology , surgery
Graft‐versus‐host disease (Gv HD ) is a common complication following haematopoietic stem cell transplant but little is published about the impact of this condition on hospital readmission rates. We report a retrospective analysis of readmission rates and associated costs in 187 consecutive allogeneic transplant patients to assess the impact of G v HD . The overall readmission rate was higher in patients with G v HD (86% (101/118) vs. 59% (41/69), p < 0.001). The readmission rate was higher both in the first 100 d from transplant (p = 0.02) and in the first year following transplant (p < 0.001). 151/455 (33%) of all readmission episodes occurred within 100 d of transplant. The mean number of inpatient days was significantly higher in patients with grade III / IV acute G v HD (101 d) compared with those with grade I / II G v HD (70 d; p = 0.003). The mean cost of readmission was higher in patients with G v HD (£28 860) than in non‐ G v HD patients (£13 405; p = 0.002) and in patients with grade III / IV G v HD (£40 012) compared with those patients with grade I / II G v HD (£24 560; p = 0.038). Survival was higher in those with grade I / II G v HD (55%) compared to grade III / IV G v HD (14%; p < 0.001). This study shows the high economic burden and poor overall survival associated with grade III / IV G v HD .