Transplantation: Patient- and Center-Level Factors Influence Readmission

doi: 10.1097/01.NEP.0000426013.08461.2e
In Brief

The overall early hospital readmission (EHR) rate after kidney transplantation (KT) was 31%, and 19 independent patient-level factors were identified as associated with readmission, reported a study published in the American Journal of Transplantation (2012;12:3283–3288).

The senior author of the study was Dorry L. Segev, MD, PhD, of the Department of Surgery at Johns Hopkins University School of Medicine and the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health.

Of the 32,961 Medicare-primary kidney transplant recipients in the study population, 10,052 (31%) recipients had an early hospital readmission. The mean time to EHR was 10.1 days, and the mean cost of readmissions was $10,551.

There was a 6% increase in the risk of early hospital readmission for every 10-year increase in age at kidney transplantation. A 40% increase in EHR risk was observed for those over 70 years old.

African-American recipients had an 11% higher risk of EHR. Some associated comorbid conditions included ischemic heart disease (relative risk 1.08), chronic obstructive pulmonary disease (RR 1.19), and obesity (RR 1.15). Compared with recipients who received a kidney from a live donor, those who received a kidney from an expanded criteria deceased donor had a 12% higher risk of early hospital readmission.

The unadjusted rate of EHR by center ranged from 18% to 47%. Some factors like percent African-American kidney transplant recipients, percent deceased donors, and percent kidney transplant recipients over age 60 were not statistically significantly associated with early hospital readmission.

“Recipients at risk could be targeted for better transitions of care and coordination of care at discharge from KT,” the study authors wrote. “Furthermore, KT recipients at high risk for early hospital readmission may be targeted for earlier or more frequent outpatient follow-up.”

© 2012 Lippincott Williams & Wilkins, Inc.