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1. High readmission rates are associated with a significant economic burden and poor outcome in patients with grade III/ IV acute Gv HD.

Author

Dignan, Fiona L., Potter, Mike N., Ethell, Mark E., Taylor, Matthew, Lewis, Lily, Brennan, Joy, McNamara, Louise, Evans, Steve O., Riley, Unell, Davies, Faith E., Dearden, Claire E., Morgan, Gareth J., and Shaw, Bronwen E.

Subjects
PATIENT readmissions, MEDICAL economics, HEALTH outcome assessment, GRAFT versus host disease, HEMATOPOIETIC stem cell transplantation, COMPLICATIONS from organ transplantation, RETROSPECTIVE studies, PATIENTS
Abstract

Graft-versus-host disease (Gv HD) is a common complication following haematopoietic stem cell transplant but little is published about the impact of this condition on hospital readmission rates. We report a retrospective analysis of readmission rates and associated costs in 187 consecutive allogeneic transplant patients to assess the impact of Gv HD. The overall readmission rate was higher in patients with Gv HD (86% (101/118) vs. 59% (41/69), p < 0.001). The readmission rate was higher both in the first 100 d from transplant (p = 0.02) and in the first year following transplant (p < 0.001). 151/455 (33%) of all readmission episodes occurred within 100 d of transplant. The mean number of inpatient days was significantly higher in patients with grade III/ IV acute Gv HD (101 d) compared with those with grade I/ II Gv HD (70 d; p = 0.003). The mean cost of readmission was higher in patients with Gv HD (£28 860) than in non- Gv HD patients (£13 405; p = 0.002) and in patients with grade III/ IV Gv HD (£40 012) compared with those patients with grade I/ II Gv HD (£24 560; p = 0.038). Survival was higher in those with grade I/ II Gv HD (55%) compared to grade III/ IV Gv HD (14%; p < 0.001). This study shows the high economic burden and poor overall survival associated with grade III/ IV Gv HD. [ABSTRACT FROM AUTHOR]

Published
2013
Full Text
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2. Clinical profile and outcome of urotheliotropic viral haemorrhagic cystitis following haematopoietic stem cell transplantation: a 7-year tertiary centre analysis.

Author

Anoop, Parameswaran, Shaw, Bronwen E, Riley, Unell, Ethell, Mark E, Taj, Mary, Lancaster, Donna L, Atra, Ayad, Saso, Radovan, Littlewood, Simon, Mohammed, Kabir, Davies, Faith, Treleaven, Jennie, Morgan, Gareth J, and Potter, Mike N

Subjects
CYSTITIS, HEALTH outcome assessment, HEMATOPOIETIC stem cells, STEM cell transplantation, CLINICAL trials, DISEASE risk factors, GRAFT versus host disease, CYCLOPHOSPHAMIDE, PATIENTS
Abstract

Viral haemorrhagic cystitis (HC) is a significant complication after haematopoietic stem cell transplantation (HSCT), with a potential for major morbidity. The aim of this 7-year analysis of 1160 HSCT patients was to evaluate risk factors for the incidence, severity, toxicity of therapy, clinical course, and outcome of this condition. The overall incidence of HC was 5·8%, with most cases occurring after allogeneic HSCT. Unrelated donors (P = 0·001), non-peripheral blood stem cell source (P = 0·005), myeloablative conditioning (P<0·001), use of alemtuzumab in conditioning (P = 0·001), and severe acute graft versus host disease (P<0·001) were independent risk factors for an increased incidence of HC post-allogeneic transplant on multivariate analysis. Severe forms of HC were associated with grades II-IV acute graft versus host disease and a longer duration of haematuria. Contrary to previous studies which were carried out on smaller patient populations, busulphan, cyclophosphamide, anti-thymocyte globulin, and total body irradiation were not found to independently increase the risk of viral HC, unless used in a myeloablative combination. Neither duration of viriuria nor peak viral load in urine influenced the severity of HC on multivariate analysis. Severe HC contributed to the deaths of two patients. Overall survival was not statistically different between patient subgroups with non-severe and severe HC. [ABSTRACT FROM AUTHOR] </p></dd> <dt class="blacklight-eds_authors col-md-3">Published</dt> <dd class="col-md-9 blacklight-eds_authors">2011</dd> <dt class="blacklight-eds_authors col-md-3"><span class="tags-custom">Full Text</span></dt> <dd class="col-md-9 blacklight-eds_authors"><a class="pdf-blue-icon" target="_blank" href="https://doi.org/10.1179/102453311X13025568941763">View/download PDF</a></dd> </dl> </article> </div> </div> </div> <div class='alternate-catalog' data-alternate-catalog="/catalog?q=%22Riley%2C+Unell%22"> <button type='button' class='alternate-catalog-close close' aria-label="Close"> <i class='fa fa-times-circle'></i> </button> <h3 class='alternate-catalog-title'></h3> <div class='alternate-catalog-body'> <div class='row'> <div class='col-md-6'> <h4 class="alternate-catalog-name"> Catalog </h4> <div class='alternate-catalog-desc'> Books, media, physical & digital resources </div> </div> <div class='col-md-6'> <a class="btn btn-primary" href="/catalog?q=%22Riley%2C+Unell%22"> See <span class="alternate-catalog-count"%></span> catalog results </a> </div> </div> <div class='row alternate-catalog-facet-section'> <div class='col-md-12'> <ul class="alternate-catalog-facets list-inline"> </ul> </div> </div> </div> </div> <div class="modal fade" id="loginModal" tabindex="-1" role="dialog"> <button type="button" id="loginclose" class="close" data-dismiss="modal" aria-label="Close"> <span aria-hidden="true">×</span> </button> <div class="modal-dialog" role="document"> <h5>Discovery Service for Jio Institute Digital Library</h5> <br /> <p>For full access to our library's resources, please sign in.</p> </div> <div class="login-modal-button-wrapper"> <button class="login-modal-sign-in"> <a rel="nofollow" data-method="post" href="/users/auth/saml">Sign In</a> </button> </div> </div> </section> </div> </main> <footer class="navbar navbar-inverse site-footer" style="position: static;"> <div class="container footer-container"> <div class="row"> <div class="col-xs-12 col-md-3 py-4 align-self-center site-footer-links-column"> <div class="footer-logo center-block"> <a href="https://library.jioinstitute.edu.in"> <img class="logo-img" src="/assets/Jio-DLLogo-b5a8a0808ea64b7ff5d156e304a4a034eee76224caf66c04cead90a411971fad.png" /> </a> </div> </div> <div class="col-xs-12 col-md-8 py-3 pb-5 pb-md-3 site-footer-links-column align-self-center"> <div class="row text-center footer-links-row"> <div class="col-4 col-sm-2"> <div class="navlink"><a href="https://library.jioinstitute.edu.in/contact">Contact</a></div> </div> <div class="col-4 col-sm-3"> <div class="navlink"><a href="https://library.jioinstitute.edu.in/access/covid-19-advisory">Covid-19 Advisory</a></div> </div> <div class="col-4 col-sm-2"> <div class="navlink"><a href="https://library.jioinstitute.edu.in/access/policies">Policies</a></div> </div> </div> </div> </div> </div> <div class="row text-center secondary-footer"> <div class="container"> <div class="col-xs-12 col-md-2 px-0"> <div class="footer-logo"> <a href="https://jioinstitute.edu.in/"> <img class="logo-img" src="/assets/JioLogoWhite-3a250c43ad67a5117225db9885c1ac0b116f92a0df0839e850e68dfbbce66ae7.png" /> </a> </div> </div> <div class="col-md-1 col-4 py-1 py-md-3"> <div class="navlink footer-navlink"><a href="https://jioinstitute.edu.in/about">About Us</a></div> </div> <div class="col-md-1 col-4 py-1 py-md-3"> <div class="navlink footer-navlink"><a href="https://jioinstitute.edu.in/academics">Academics</a></div> </div> <div class="col-md-1 col-4 py-1 py-md-3"> <div class="navlink footer-navlink"><a href="https://jioinstitute.edu.in/research-overview">Research</a></div> </div> <div class="col-md-1 col-4 py-1 py-md-3 pl-0 pr-0"> <div class="navlink footer-navlink"><a href="https://jioinstitute.edu.in/campus-life"> Campus Life</a></div> </div> <div class="col-md-1 col-4 py-1 py-md-3"> <div class="navlink footer-navlink"><a href="https://jioinstitute.edu.in/contacts"> Contact</a></div> </div> <div class="col-md-4 col-4 py-1 py-md-3"> <div class="navlink footer-navlink float-right"><a href="https://jioinstitute.edu.in/terms-conditions">T&C</a></div> </div> <div class="col-md-1 col py-1 py-md-3 pl-0"> <div class="navlink footer-navlink float-right"><a href="https://jioinstitute.edu.in/privacy-policy"> Privacy Policy</a></div> </div> </div> </div> <!-- Global site tag (gtag.js) - Google Analytics --> <script async src=https://www.googletagmanager.com/gtag/js?id=G-R4B0KJQ5EY></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-R4B0KJQ5EY'); </script> </footer> <div id="blacklight-modal" class="modal fade" tabindex="-1" role="dialog" aria-hidden="true"> <div class="modal-dialog modal-lg" role="document"> <div class="modal-content"> </div> </div> </div> </body> </html>