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The association of discharge decisions after deceased donor kidney transplantation with the risk of early readmission: Results from the deceased donor study
Author(s) -
Harhay Meera Nair,
Jia Yaqi,
ThiessenPhilbrook Heather,
Besharatian Behdad,
Gumber Ramnika,
Weng Francis L.,
Hall Isaac E.,
Doshi Mona,
Schroppel Bernd,
Parikh Chirag R.,
Reese Peter P.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13215
Subject(s) - medicine , confidence interval , odds ratio , retrospective cohort study , kidney transplantation , hospital discharge , cohort study , cohort , odds , emergency medicine , transplantation , kidney transplant , logistic regression
Abstract Background Kidney transplant (KT) recipients experience high rates of early (≤30 days) hospital readmission (EHR) after KT, and existing studies provide limited data on modifiable discharge factors that may mitigate EHR risk. Methods We performed a retrospective cohort study of 468 adult deceased donor KT recipients transplanted between 4/2010 and 11/2013 at 5 United States transplant centers. We fit multivariable mixed effects models to assess the association of two potentially modifiable discharge factors with the probability of EHR after KT: (i) weekend discharge and (ii) days to first scheduled follow‐up. Results Among 468 KT recipients, 38% (n = 178) experienced EHR after KT. In fully adjusted analyses, compared to weekday discharges, KT recipients discharged on the weekend had a 29% lower risk of EHR (adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.41‐0.94). Compared to follow‐up within 2 days of discharge, KT recipients with follow‐up within 3 to 6 days had a 28% higher probability of EHR (aOR 1.28, 95% CI 1.13‐1.45). Conclusions These findings suggest that clinical decisions related to the timing of discharge and follow‐up modify EHR risk after KT, independent of traditional risk factors.