Hospitalization databases: a tool for transplantation monitoring

We sought to account for changes in posttransplant hospitalization patterns in terms of the changes in demographic and transplantation-related variables.

We retrospectively analyzed 1860 cases of kidney transplantation performed between 1992 and 2004 in terms of demographic and transplantation-related variables. Of the 1860 cases, rehospitalization records in the first year posttransplantation were available for 1152 cases, which were assessed for causes of admission, mortality, graft loss, length of stay, and hospital charges.

The pattern of rehospitalizations showed the following trends: (1) Increased rate of infection; (2) Decreased rate of graft rejection; and (3) Peak costs of rehospitalization between 1999 and 2000.

We believed that the increased infection rate and decreased rejection rate may have been related at least partly to the shift in the treatment protocol from azathioprine-based to mycophenolate mofetil regimens in 2000. Furthermore, the peak in the relative frequency of diabetes mellitus and hypertension as the etiology of end-stage renal disease among those having undergone transplantation between 1999 and 2000 may have been responsible for the peak in rehospitalization costs and length of hospital stay. We are strongly of the opinion that hospital statistics are a valuable tool for health care policymakers to monitor transplantation outcomes.