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Readmission risks after stem cell transplants

Most common reasons for readmission of patients after haematopoietic cell transplants are infections and gastrointestinal symptoms, a study shows

The most common reasons for readmission of patients after haematopoietic cell transplants are infections and gastrointestinal symptoms, a study shows

Picture shows a patient receiving a bone marrow autotransplant, in which high doses of chemotherapy or radiation therapy are followed by infusion of the patient’s own stem cells.
Picture: Science Photo Library

When patients need to be readmitted to hospital within 30 days of a stem cell transplant – which may lead to significant healthcare costs – the most common reasons are infections and gastrointestinal symptoms, a US study shows.

Such transplants are the intravenous infusion of autologous stem cells – the patient’s own cells – or allogeneic cells from a matching donor.

The procedure re-establishes the blood cell-forming tissue, function and capacity of the marrow in patients with bone marrow disorder, defects or damage.

It is associated with significant morbidity and mortality.

Readmission rates higher in centres with lower transplant volume and activity

The study examined the rates and risk factors related to 30-day readmission following the procedure. It looked at data on adult patients from the US population-based Nationwide Readmissions Database, which collects information on hospital inpatient stays, between January 2012 and November 2014.

Overall 30-day readmission rates were 11.6% for autologous haematopoietic cell transplants and 24.4% for allogeneic ones, it found.

Readmission rates were higher in centres with lower transplant volume and activity.

Infection-related complications were the most common reason for readmission for both forms of transplant, with gastro-intestinal symptoms and febrile neutropenia also identified as major causes of readmission.

Being young and female was associated with higher rates in patients undergoing autologous haematopoietic cell transplants. The development of graft versus host disease was found to be significant reason for readmission in patients who underwent allogeneic transplants.


Reference

Dhakal B, Giri S, Levin A et al (2019) Factors associated with unplanned 30-day readmissions after hematopoietic cell transplantation among US hospitals JAMA Network Open. 2019;2(7):e196476. doi:10.1001/jamanetworkopen.2019.6476


Compiled by Dion Smyth, lecturer-practitioner in cancer and palliative care at Birmingham City University

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