The association of discharge decisions after deceased donor kidney transplantation with the risk of early readmission: Results from the deceased donor study

• DOI: 10.1111/ctr.13215
• Publication Date: 2018-02-02T10:32:45Z
• Authors: Meera Nair Harhay; Yaqi Jia; Heather Thiessen‐...; Behdad Besharatian; Ramnika Gumber; Francis L. Weng; Isaac E. Hall; Mona Doshi; Bernd Schroppel; Chirag R. Parikh; Peter P. Reese
• Keywords: Adult; Graft Rejection; Male; Graft Survival; Middle Aged; Kidney Function Tests; Prognosis; Kidney Transplantation; Patient Readmission; Patient Discharge; Tissue Donors; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Cadaver; Humans; Kidney Failure, Chronic; Female; Follow-Up Studies; Glomerular Filtration Rate

AbstractBackgroundKidney transplant (KT) recipients experience high rates of early (≤30 days) hospital readmission (EHR) after KT, and existing studies provide limited data on modifiable discharge factors that may mitigate EHR risk.MethodsWe performed a retrospective cohort study of 468 adult deceased donor KT recipients transplanted between 4/2010 and 11/2013 at 5 United States transplant centers. We fit multivariable mixed effects models to assess the association of two potentially modifiable discharge factors with the probability of EHR after KT: (i) weekend discharge and (ii) days to first scheduled follow‐up.ResultsAmong 468 KT recipients, 38% (n = 178) experienced EHR after KT. In fully adjusted analyses, compared to weekday discharges, KT recipients discharged on the weekend had a 29% lower risk of EHR (adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.41‐0.94). Compared to follow‐up within 2 days of discharge, KT recipients with follow‐up within 3 to 6 days had a 28% higher probability of EHR (aOR 1.28, 95% CI 1.13‐1.45).ConclusionsThese findings suggest that clinical decisions related to the timing of discharge and follow‐up modify EHR risk after KT, independent of traditional risk factors.