Causative factors for prolonged hospitalization beyond the point of engraftment in patients after autologous peripheral blood stem cell transplantation

Abstract

Summary:In order to assess the incidence and analyze reasons which cause prolongation of hospital stay in patients engrafted after peripheral blood stem cell transplantation (PBSCT), we performed this retrospective analysis. One hundred patients (receiving 123 conditioning regimens) were included in the analysis. Criteria for discharge were presence of myeloid engraftment and absence of severe concomitant problems. Ninety subjects (73%) were discharged just after engraftment was reached on day +12 (10-14). Discharge was delayed in 33 patients (27%) and the mean prolongation was 3 days (1-11). In 31 patients (25%) delayed discharge was due to complications: in 14 patients (11.4%) because of GIT problems, in 16 patients (13%) because of infectious complications and in one patient because of cardiotoxicity. A significantly higher number of infectious complications was found in patients conditioned with BEAM (19.7% vs 4.2%, P Ͻ 0.05) while GIT toxicity was the most common reason for discharge delays in patients conditioned with melfalan 200 mg/m 2 (8.2% vs 14.7%, NS). No risk factors of hospital stay prolongation were determined. We conclude that in spite of rapid engraftment, non-hematological toxicities and infections remain important limitations for further reduction of the length of patient hospitalization in a significant number of patients after PBSCT. Bone Marrow Transplantation (2000) 26, 877-880.

Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation

“…[53][54][55][56] We have found only one prospective study in which costs of SCT were analyzed by using admission and in-hospital risk factors (not including psychiatric measures). [53][54][55][56] We have found only one prospective study in which costs of SCT were analyzed by using admission and in-hospital risk factors (not including psychiatric measures).…”

Home care for children following haematopoietic stem cell transplantation

“…therapy, including TPN and antiviral treatment, which are the most common causes of delayed hospital discharge following transplantation. 3 In most cases, we were able to discontinue assistance when the indications for HC were solved. This meant that children who were discharged earlier from the BMT Unit did not need to be readmitted, except when severe infectious complications occurred.…”

“…3 Therefore, in the last few years, outpatient clinic management of the post-transplant follow-up has improved in most centres. However, the amount of time spent at the outpatient clinic as well as the time needed to reach the hospital represent an important cause of discomfort for children and their families.…”

The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)

“…In addition to high levels of fatigue and insomnia, the symptom experience during this phase reflects gastrointestinal (GI) toxicities characteristic of the early post-transplant period including nausea [7,9,13], anorexia [7,9,13,56], xerostomia [7,13], taste changes [7] and diarrhea [7,9,10]. Although well described, GI complications have been reported as the most debilitating side effect of HSCT [65], in some cases delaying hospital discharge [66,67] and contributing to hospital readmission following HSCT [68]. In addition, the relationship between poor nutritional status and clinical outcomes such as fever [69] and GVHD severity [70] are being explored.…”