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

• Published in: Clinical transplantation 2020-03, Vol.34 (3), p.e13822-n/a
• Main Authors: Nguyen, Michelle C., Avila, Christina L., Brock, Guy N., Benedict, Jason A., James, Iyore, El‐Hinnawi, Ashraf, Rajab, Amer, Elkhammas, Elmahdi, Pelletier, Ronald P., Henry, Mitchell, Bumgardner, Ginny L.
• Format: Article
• Language: English
• Subjects: Adult; Female; Graft Survival; hospital readmission; Humans; kidney transplant; Kidney Transplantation; length of stay; Patient Readmission; patient survival; Renal Dialysis; Risk Factors; Transplant Recipients
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.13822

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  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.