Purpose
The purpose of this study was to identify factors influencing the readmission of heart transplant recipients through survival analysis. Methods: We collected data from heart transplant recipients who were discharged after surgery between November 2005 and September 2020 from the electronic medical records of Y University Hospital in Seoul. The Kaplan-Meier estimation was utilized to calculate the survival rate, and Cox's proportional hazards model was employed to determine the factors influencing readmission within 1 year. Results: Out of 150 heart transplant recipients, 81 (54.0%) were readmitted within one year. The median time to readmission was 231 days. An increased duration of postoperative days was associated with a higher risk of readmission (p=.016). Groups with abnormal sodium levels (p<.001), those requiring postoperative hemodialysis (p=.013), patients with chronic kidney disease (p=.002), dyslipidemia (p=.040), or diabetes mellitus (p=.045) also faced higher readmission risks. In the final model, sodium levels (hazard ratio [HR]=2.31, p<.001) and chronic kidney disease (HR=1.67, p=.045) were significant risk factors for readmission (x² =31.90, p<.001). Conclusion: Interventions to improve kidney function and a multidisciplinary approach are needed to reduce readmission of heart transplant recipients.

PURPOSE
This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review.
METHODS
From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression.
RESULTS
Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups.
CONCLUSION
Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.

Citations

• COPD Prevalence and Risk Factors in Korean Older Adults
  Do-Youn Lee
  The Journal of Korean Physical Therapy.2025; 37(1): 31.     CrossRef
• Development of a smartphone application for Korean patients with chronic obstructive pulmonary disease: Self-monitoring based action plans
  Ja Yun Choi, Maureen George, So Young Yun
  Applied Nursing Research.2021; 61: 151475.     CrossRef