Incidence of and Risk Factors for Multiple Readmissions after Kidney Transplantation

Abstract

Unplanned readmission is often used as a surgical quality metric. A subset of kidney transplant recipients undergos multiple readmissions (MRs), although the incidence and risk factors are not well described. The aim of this study was to evaluate risk factors for MR after deceased donor kidney transplantation. All patients undergoing deceased donor kidney transplantation at a single center over a three-year period were analyzed via retrospective chart review for factors associated with MR. P values <0.05 were considered significant. Of 141 patients, the 30-day readmission rate was 26.2 per cent. MR occurred in 43 (30.5%) patients. Age, race, gender, initial organ function, and dialysis vintage were not associated with MR. Diabetic recipients, those who received basiliximab induction, those with acute rejection, and those with unplanned reoperations were at increased risk for MR. Infection was the most common reason for initial readmission in patients with MR (23.3%). One-year patient survival and death-censored graft survival were reduced for patients with MR. MRs are required for 30 per cent of kidney transplant recipients, primarily because of infection and immunologic causes. Recipients with diabetes and those who have acute rejection are at greatest risk.

Factors associated with readmission in chronic kidney disease: Systematic review and meta‐analysis

“…Within the CKD G1T‐G5T group, six studies included two to four readmission timepoints (Dunn et al, 2018; Grupper et al, 2019; Nguyen et al, 2020; Schucht et al, 2019; Schucht et al, 2020; Stoll et al, 2016; Whitlock et al, 2017), with 30‐day being most commonly measured. From the remaining 26 studies which had a single readmission timepoint, 30‐day was the most commonly measured ( n = 17) and other timepoints were 3‐month (Leal et al, 2017), 6‐month (Saleem et al, 2003), 1‐year (Anderson et al, 2017; Hogan et al, 2019; Lynch et al, 2016) and various readmission periods from 7.8 months to 22 years (Hosseini et al, 2007; Taber et al, 2013; Vranian et al, 2018).…”