成年肾移植受者术后非计划再入院的影响因素分析

曹韦韦; 钟明欢; 孙州; 梁国富; 严富; 刘超; 马丽; 朱科静; 许艳艳; 丁蓓; 牛玉林

doi:10.7619/jcmp.20242354

成年肾移植受者术后非计划再入院的影响因素分析

Influencing factors for unplanned re-hospitalization in adult renal transplant recipients after surgery

摘要

摘要:
目的探讨成年肾移植受者术后1年内非计划再入院的影响因素。
方法回顾性分析2020年1月—2022年12月在贵州医科大学附属医院器官移植科行肾移植手术的299例受者的临床资料。根据术后1年内是否发生非计划再入院, 将受者分为非计划再入院组和未再入院组，通过单因素分析和二元Logistic回归分析探讨肾移植受者术后1年内非计划再入院的影响因素。
结果 299例受者中, 102例发生非计划再入院，发生率为34.11%。单因素分析结果显示, 2组受者性别、职业状况、术前基础病、排斥反应、院内感染情况、免疫抑制用药方案、血肌酐、胱抑素C、血磷、血钾及首次住院时间比较，差异有统计学意义(P < 0.05)。二元Logistic回归分析结果显示，术前基础病≥3种(OR=2.122，95%CI: 1.198~3.759)、有排斥反应(OR=3.162，95%CI: 1.217~8.218)是肾移植受者术后1年内非计划再入院的独立危险因素(P < 0.05)。
结论成年肾移植受者术后1年内非计划再入院率较高，术前基础病≥3种、有排斥反应是术后1年内非计划再入院的独立危险因素。移植医护团队可针对危险因素制订相应对策，以降低受者非计划再入院率，减轻疾病负担。

Abstract:
Objective To investigate the influencing factors of unplanned rehospitalization within one year after surgery among adult renal transplant recipients.
Methods The clinical data of 299 recipients who underwent renal transplant surgery in the Department of Organ Transplantation of the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were retrospectively analyzed. The recipients were divided into unplanned rehospitalization group and non-rehospitalization group based on whether they experienced unplanned rehospitalization within one year after surgery. Univariate analysis and binary Logistic regression analysis were performed to explore the influencing factors of unplanned rehospitalization within one year after renal transplantation.
Results Among the 299 recipients, 102 experienced unplanned rehospitalization, with an incidence rate of 34.11%. Univariate analysis revealedstatistically significant differences were noted between the two groups in terms of gender, occupational status, preoperative underlying disease, rejection reactions, nosocomial infections, immunosuppressive medication regimens, serum creatinine, cystatin C, serum phosphorus, serum potassium, and initial hospitalization duration (P < 0.05). Binary Logistic regression analysis showed that having ≥3 kinds of preoperative underlying disease (OR=2.122, 95%CI, 1.198 to 3.759) and experiencing rejection reactions (OR=3.162, 95%CI, 1.217 to 8.218) were independent risk factors for unplanned rehospitalization within one year after renal transplantation (P < 0.05).
Conclusion The rate of unplanned rehospitalization within one year after surgery is relatively high among adult renal transplant recipients. Having ≥3 preoperative underlying disease and experiencing rejection reactions are independent risk factors for unplanned rehospitalization within one year after surgery. Transplantation healthcare teams can develop corresponding strategies targeting these risk factors to reduce the rate of unplanned rehospitalization and alleviate the burden of disease.

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