Document Detail

Early hospital readmission after kidney transplantation: patient and center-level associations.
MedLine Citation:
PMID:  23016838     Owner:  NLM     Status:  MEDLINE    
Early hospital readmission (EHR) is associated with increased morbidity, costs and transition-of-care errors. We sought to quantify rates of and risk factors for EHR after kidney transplantation (KT). We studied 32 961 Medicare primary KT recipients (2000-2005) linked to Medicare claims through the United States Renal Data System. EHR was defined as at least one hospitalization within 30 days of initial discharge after KT. The association between EHR and recipient and transplant factors was explored using Poisson regression; hierarchical modeling was used to account for study center-level differences. The overall EHR rate was 31%, and 19 independent patient-level factors associated with EHR were identified: recipient factors included older age, African American race and various comorbidities; transplant factors included ECD, length of stay and lack of induction therapy. The unadjusted rate of EHR by center ranged from 18% to 47%, but conventional center-level factors (percent African American, percent age > 60, percent deceased donor and percent expanded criteria donor) were not associated with EHR. However, intermediate total volume and average length of stay were associated with increased EHR risk. Better identification of patients at risk for early hospital readmission following KT may guide discharge planning and early posttransplant outpatient monitoring.
M A McAdams-Demarco; M E Grams; E C Hall; J Coresh; D L Segev
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2012-09-27
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  12     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2013-05-14     Revised Date:  2014-05-05    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3283-8     Citation Subset:  IM    
Copyright Information:
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
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MeSH Terms
African Americans
European Continental Ancestry Group
Follow-Up Studies
Kidney Transplantation*
Living Donors
Longitudinal Studies
Middle Aged
Patient Discharge
Patient Readmission / statistics & numerical data*
Risk Factors
Grant Support
234-2005-370011C//PHS HHS; K23AG032885/AG/NIA NIH HHS; R21DK085409/DK/NIDDK NIH HHS
Comment In:
Nat Rev Nephrol. 2014 Apr;10(4):188-9   [PMID:  24595039 ]
J Urol. 2013 Aug;190(2):593   [PMID:  23845352 ]
Am J Transplant. 2012 Dec;12(12):3171-2   [PMID:  23198785 ]

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