Increasing age and longer initial hospital stays were associated with higher 30-day readmission risk in CKD and transplant patients, while nephrologist follow-up within 14 days was protective.
Meta-Analysis
What are the risk factors and protectors associated with all-cause 30-day hospital readmission in adult patients with chronic kidney disease?
In patients with chronic kidney disease, increasing age and length of initial hospital stay increase 30-day readmission risk, whereas early nephrologist follow-up is protective.
Abstract Background Risk factors associated with all‐cause hospital readmission are poorly characterised in patients with chronic kidney disease. Objective A systematic review and meta‐analysis were conducted to identify risk factors and protectors of hospital readmission in chronic kidney disease. Design, Participants dialysis, n = 34 studies; and transplant, n = 32 studies) were identified. Meta‐analysis revealed that in both chronic kidney disease and transplant groups, increasing age in years and days spent at the hospital during the initial stay were associated with a higher risk of 30‐day readmission. Other risk factors identified included increasing body mass index (kg/m 2 ) in the transplant group, and functional impairment and discharge destination in the dialysis group. Within the chronic kidney disease group, having an outpatient follow‐up appointment with a nephrologist within 14 days of discharge was protective against readmission but this was not protective if provided by a primary care provider or a cardiologist. Conclusion Risk‐reduction interventions that can be implemented include a nephrologist appointment within 14 days of hospital discharge, rehabilitation programme for functional improvement in the dialysis group and meal plans in the transplant group. Future risk analysis should focus on modifiable factors to ensure that strategies can be tested and implemented in those who are more at risk.
Low et al. (Sat,) conducted a meta-analysis in Chronic kidney disease. Risk factors and protectors was evaluated on All-cause 30-day hospital readmission. Increasing age and longer initial hospital stays were associated with higher 30-day readmission risk in CKD and transplant patients, while nephrologist follow-up within 14 days was protective.