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A single‐center analysis of early readmission after renal transplantation
Author(s) -
Kim Steffan H.,
Baird Grayson L.,
Bayliss George,
Merhi Basma,
Osband Adena,
Gohh Reginald,
Morrissey Paul E.
Publication year - 2019
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.13520
Subject(s) - medicine , transplantation , kidney transplantation , renal function , emergency medicine , intensive care medicine , donation , single center , database , computer science , economics , economic growth
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.