"Early" and "Late" Hospital readmissions in the first year after kidney transplant at a single center.

Autor: Nguyen MC; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Avila CL; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio.; Medical Student Research Program, The Ohio State University College of Medicine, Columbus, Ohio., Brock GN; Center for Biostatistics, The Ohio State University, Columbus, Ohio., Benedict JA; Center for Biostatistics, The Ohio State University, Columbus, Ohio., James I; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., El-Hinnawi A; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Rajab A; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Elkhammas E; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Pelletier RP; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Henry M; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio., Bumgardner GL; Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2020 Mar; Vol. 34 (3), pp. e13822. Date of Electronic Publication: 2020 Mar 02.
DOI: 10.1111/ctr.13822
Abstrakt: Background: Hospital readmission (HR) after surgery is considered a quality metric.
Methods: Data on 2371 first-time adult kidney transplant (KT) recipients were collected to analyze the "early" (≤30 days) and "late" (31-365 days) HR patterns after KT at a single center over a 12-year time span (2002-2013).
Results: 30-day, 90-day, and 1-year HR were 31%, 41%, and 53%, respectively. Risk factors for HR included age >50, female sex, black race, BMI >30, transplant LOS >5 days, and pre-transplant time on dialysis >765 days. Indications for early (n = 749) and late (n = 508) HR were similar. Early HR (OR: 3.80, P = .007) and black race (OR: 2.38, P = .009) were associated with higher odds of 1-year graft failure while frequency (1-2, 3-4, 5+) of HR (ORs: 4.68, 8.36, 9.44, P < .001) and age > 50 (OR: 2.11, P = .007) were associated with higher odds of 1-year mortality. Transplant LOS > 5 days increased both odds of 1-year graft failure (OR: 3.51, P = .001) and mortality (OR: 2.05, P = .006). One-year graft and recipient survival were 96.7% and 94.8%, respectively.
Conclusions: Hospital readmission was associated with reduced graft and patient survival; however, despite a relatively high and consistent HR rate after KT, overall 1-year graft and patient survival was high.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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