Sequelae of Early Hospital Readmission After Kidney Transplantation. Issue 2 (21st January 2014)

• Record Type: Journal Article
• Authors: McAdams‐DeMarco, M. A.; Grams, M. E.; King, E.; Desai, N. M.; Segev, D. L.
• Is Part Of: American journal of transplantation. Volume 14:Issue 2(2014:Feb.)
• Page Start: 397
• Page End: 403
• Publication Date: 2014-01-21
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.12563
• Languages: English
• ISSNs: 1600-6135

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajt12563-sec-0001" sec-type="section"> <p>We recently elucidated risk factors for early hospital readmission (EHR) following kidney transplantation (KT). We now sought to quantify the independent associations between EHR and post‐KT outcomes, including late hospital readmission (LHR: 1 year after EHR window), death‐censored graft loss and mortality, among Medicare‐primary KT recipients (2000–2005). Of 32 961 KT recipients, 7.7% had at least one readmission within 3 days of discharge, 14.8% within 7 days, 22.4% within 14 days and 30.5% within 30 days of discharge after the initial KT hospitalization. KT recipients who experienced EHR within 30 days of discharge after the initial KT hospitalization were more likely to have experienced LHR (29.6% vs. 9.0%, p < 0.001) and were at 3.02 times higher (95% CI: 2.82–3.23, p < 0.001) risk of LHR. Additionally, EHR was associated with death‐censored graft loss (deceased donor recipients hazard ratio [HR]: 1.43, 95% CI: 1.36–1.51, p < 0.001 and live donor recipients HR: 1.54, 95% CI: 1.40–1.70, p < 0.001) and mortality (deceased donor recipients HR: 1.50, 95% CI: 1.43–1.58, p < 0.001 and live donor recipients HR: 1.45, 95% CI: 1.32–1.60, p < 0.001). Thirty days posttransplant represents a high‐risk window for KT recipients and the readmissions during this window are strong predictors of adverse sequelae, particularly LHRs. Efforts should be made to implement and improve systems to reduce LHR and subsequent graft loss and mortality among recipients with EHR.</p> </sec> </abstract>