Incidence, predictors, and outcomes of early hospital readmissions after kidney transplantation: Systemic review and meta-analysis.

Autor:	Iqbal K; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Hasanain M; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Rathore SS; Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India., Iqbal A; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Kazmi SK; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Yasmin F; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Koritala T; Department of Internal Medicine, Mayo Clinic Health System, Mankato, MN, United States., Thongprayoon C; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States., Surani S; Department of Pulmonology, Texas A&M University College of Medicine, Bryan, TX, United States.; Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Nov 04; Vol. 9, pp. 1038315. Date of Electronic Publication: 2022 Nov 04 (Print Publication: 2022).
DOI:	10.3389/fmed.2022.1038315
Abstrakt:	Background: Early hospital readmission (EHR) within 30 days after kidney transplantation is a significant quality indicator of transplant centers and patient care. This meta-analysis aims to evaluate the incidence, predictors, and outcomes of EHR after kidney transplantation. Methods: We comprehensively searched the databases, including PubMed, Cochrane CENTRAL, and Embase, from inception until December 2021 to identify studies that assessed incidence, risk factors, and outcome of EHR. The outcomes included death-censored graft failure and mortality. Data from each study were combined using the random effect to calculate the pooled incidence, mean difference (MD), odds ratio (OR), and hazard ratio (HR) with 95% confidence interval (CI). Results: A total of 17 studies were included. The pooled EHR incidence after kidney transplant was 24.4% (95% CI 21.7-27.3). Meta-analysis showed that recipient characteristics, including older recipient age (MD 2.05; 95% CI 0.90-3.20), Black race (OR 1.31; 95% CI 1.11, 1.55), diabetes (OR 1.32; 95% CI 1.22-1.43), and longer dialysis duration (MD 0.85; 95% CI 0.41, 1.29), donor characteristics, including older donor age (MD 2.02; 95% CI 0.93-3.11), and transplant characteristics, including delayed graft function (OR 1.75; 95% CI 1.42-2.16) and longer length of hospital stay during transplantation (MD 1.93; 95% CI 0.59-3.27), were significantly associated with the increased risk of EHR. EHR was significantly associated with the increased risk of death-censored graft failure (HR 1.70; 95% CI 1.43-2.02) and mortality (HR 1.46; 95% CI 1.27-1.67) within the first year after transplantation. Conclusion: Almost one-fourth of kidney transplant recipients had EHR within 30 days after transplant, and they had worse post-transplant outcomes. Several risk factors for EHR were identified. This calls for future research to develop and implement for management strategies to reduce EHR in high-risk patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Iqbal, Hasanain, Rathore, Iqbal, Kazmi, Yasmin, Koritala, Thongprayoon and Surani.)
Databáze:	MEDLINE
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