Key result
Early hospital readmission occurred in 21% of kidney transplant recipients and was not significantly correlated with risk of death at 44 months (HR 2.2; 95% CI 0.7-6.6; P=0.1473).
Why the study?
What are the risk factors for early hospital readmission after renal transplantation?
Observational (n=269)
No
What are the risk factors for early hospital readmission after renal transplantation?
Hazard Ratio: 2.2 (95% CI 0.7–6.6)
p-value: p=0.1473
Early hospital readmission after renal transplantation is common (21%) and associated with specific risk factors, but does not correlate with an increased risk of death or graft loss.
May identify center-specific modifiable factors in renal transplant readmissions; leaves open generalizability and practice impact.
BACKGROUND: Thirty-day readmission rates (early hospital readmission, EHR) are an important benchmark for quality improvement. Nationally, patients undergoing renal transplantation incur a 31% EHR rate. While national databases provide useful data, the impact of EHR on individual centers has received little attention. We proposed that an institutional review of EHR after renal transplantation may provide a benchmark for individual transplant programs and identify modifiable program-specific issues to reduce EHR. METHODS: We reviewed 269 consecutive kidney transplant recipients over a five-year period (2012-2016). Early hospital readmission was modeled using generalized linear modeling assuming a binary distribution. RESULTS: About 21% of patients were readmitted within 30 days. Deceased kidney donation (DD), delayed graft functioning (DGF), anti-thymocyte globulin (ATG) induction, diabetes, public insurance, weekend discharge, and low glomerular filtration rate (eGFR) at discharge were all identified as risk factors for readmission. Early hospital readmission was not correlated with risk of death (5.4% at 44 months: HR 2.2 (95% CI [0.7, 6.6]; P = 0.1473) or graft loss. CONCLUSIONS: EHR after renal transplantation is common. Certain factors may predict an increased risk for EHR. A multi-disciplinary approach to discharge planning may limit some EHR, but most complications and adverse events are unpredictable and require hospital-level of care.
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Kim et al. (2019) conducted an observational in renal transplantation (n=269). Early hospital readmission was evaluated on risk of death (HR 2.2, 95% CI 0.7, 6.6, p=0.1473). Early hospital readmission occurred in 21% of kidney transplant recipients and was not significantly correlated with risk of death at 44 months (HR 2.2; 95% CI 0.7-6.6; P=0.1473).
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