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dc.contributor.authorBrosch, Laura Ruse
dc.date.accessioned2012-04-09T14:31:08Z
dc.date.available2012-04-09T14:31:08Z
dc.date.issued1998
dc.identifier.urihttp://hdl.handle.net/10713/1374
dc.descriptionUniversity of Maryland, Baltimore. Nursing. Ph.D. 1998en_US
dc.description.abstractThe goal of kidney transplantation is to restore patients' physical function and decrease their dependence upon medical services. Rehospitalization following kidney transplant surgery is a recurrent and costly event that detracts from the ultimate aims of the intervention. The purposes of this retrospective cohort study were to: (1) estimate the rate of rehospitalization for kidney transplant recipients during 90 days following transplantation; (2) identify the reasons for readmission; and (3) identify patient-specific factors, identifiable at time of discharge, that are associated with the likelihood of rehospitalization. Twenty-two demographic and clinical factors were examined in a consecutive series of 300 patients who received kidney transplants between March 1995 and February 1997. The mean age of patients was 46.9 years (SD = 12.59). The median length of initial hospital was 9 days(IQ range = 7-15). One hundred sixty-one patients (53.7%) experienced 267 readmissions during the first 90 days following transplant surgery. Readmissions were for infection (28.8%); acute rejection (27.3%); perinephric/ureteral problems (13%) and fluid and electrolyte imbalances (7.9%). The length of initial hospital stay (median = 14 days) was longer for recipients of older kidneys (>=60 years of age) versus younger kidneys (1-59 years of age) (median = 9 days) (p =.001). The length of initial hospitalization for patients who experienced delayed graft function (median = 17.0 days) exceeded the length of stay for patients who did not (median = 8.0 days) (p < .0001). The Behavioral Model of Health Services Use provided the conceptual framework for this study. Eleven of 22 patient-specific factors were significant in univariate logistic regression and subsequently analyzed in a multivariate logistic regression model. Donor age (OR 1.2, p =.025) and delayed graft function (OR 2.32, p =.008) were significantly associated with the likelihood of rehospitalization. Charlson comorbidity score, donor/recipient CMV status, HLA-mismatch, donor source, immunosuppression, length of initial hospital stay, discharge disposition, and location of residence were not sufficiently associated with readmission to enter the model. Further research is needed to identify the patient and treatment factors associated with readmission in the early posttransplant period.en_US
dc.language.isoen_USen_US
dc.subjectHealth Sciences, Nursingen_US
dc.titleFactors associated with hospitalization in kidney transplant patientsen_US
dc.typedissertationen_US
dc.contributor.advisorWaltz, Carolyn Feher
dc.identifier.ispublishedYes
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