Purpose: Initial hospital length of stay following heart transplant is variable. The longer the hospital stay, the increased cost related to the surgery. This will be important in determining financial contracts for this patient population. We sought to evaluate what risk factors are associated with increase initial heart transplant length of stay so as to guide financial contracts for this surgery.

Methods: Between 2010 and 2013, we evaluated 340 patients and determined their initial hospital length of stay post-transplant. Our usual length of stay has ranged between 10-14 days and thus we determined a mark of 14 days as being prolonged. We then performed a multivariate analysis to assess the impact of multiple clinical variables on length of stay after heart transplant surgery, including: recipient age, donor age, history of prior sternotomy, 1A status, time listed Status 1A, recipient gender, history of pregnancies, BMI under 25, BMI over 30, CMV mismatch, history of pre-transplant coronary artery disease, ischemic time, pre-transplant hypertension, pre-transplant diabetes, pre-transplant creatinine, mechanical circulatory support prior to transplant, and need for combined organ transplant.

Results: The multivariate analysis found rising creatinine (OR 1.7, p=0.004) and prior sternotomy (OR 2.2, p=0.045) as being independent risk factors correlating to increased post-transplant length of stay. Other factors were not significant.

Conclusion: Increased hospital length of stay following heart transplant may be predicted by risk factors including elevated creatinine and prior sternotomy. These patients should be viewed as higher risk for increased financial cost and contract agreements.

« Back to 2015 American Transplant Congress