Unplanned readmission within the most recent postoperative year of heart transplant patients in Taiwan

AIMS: The aim of this study was to examine the rate of unplanned readmissions within the most recent postoperative year for heart transplant patients and the causes and contributing factors leading to such readmissions. BACKGROUND: Advances in medical technology have significantly increased the survival rate of heart transplant patients. However, several postoperative complications make it common for patients to be readmitted to hospitals. An 'unplanned readmission' rate will better reflect the quality of postdischarge care than will mortality rate alone. Little research has been conducted on the heart transplant population in Taiwan. DESIGN: Descriptive, cross-sectional. METHODS: Data were collected from a purposive sample by structured questionnaires and medical record reviews. RESULTS: Seventy-one patients were recruited at different times after heart transplantation. The unplanned readmission rate was 35.2% in the most recent postoperative year. The unplanned readmission rate was 52.2% for patients who had received transplantation five years ago or less, which was significantly higher than that for patients who had received transplantation more than five years ago (27.1%). Leading causes of unplanned readmission included infection (31.8%), rejection (25.0%) and cardiac allograft vasculopathy (18.2%). Blood urea nitrogen and creatinine levels were significantly higher in readmitted patients than in patients who were not (t = 2.09, p < 0.05 and t = 2.12, p < 0.05, respectively). CONCLUSION: To reduce unplanned readmissions, the health professionals must continuously evaluate and monitor for adverse effects of treatment on patients, providing suitable guidance to equip the patient with the knowledge and ability to manage symptoms appropriately. RELEVANCE TO CLINICAL PRACTICE: Continuous postoperative follow-up should be performed for patients. Nurses can function as the patient's evaluator, advisor, educator and advocator, to conduct postoperative care and carry out follow-up plans to prevent readmission.