ATC Abstracts

American Transplant Congress abstracts

Frailty and Length of Stay in KT Recipients

Johns Hopkins, Baltimore.

Meeting: 2015 American Transplant Congress

Abstract number: B227

Keywords: , ,

Session Information

Session Name: Poster Session B: Obesity/Elderly/Frail

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

BACKGROUND: In KT recipients, length of stay (LOS) is associated with early hospital readmission; yet, predictors of KT LOS are unclear.

METHODS: Registry-based predictors of KT LOS were identified using SRTR data (2002-2014, n=63,286). In a single-center cohort of 589 KT recipients at JHH, frailty was measured at the time of admission for KT (12/2008-5/2014). To improve model efficiency in our single-center study, negative binomial regression models were adjusted for confounders feeding the coefficients from the registry-based model back into the single-center model, where the only coefficient estimated was that of frailty.

RESULTS: Nationally, the median LOS has decreased (1995: 8 days; 2014: 5 days). Recipient, transplant and donor factors were associated with KT LOS.

Correlates of Kidney Transplantation Length of Stay Using SRTR data (2002-2014, n=63,286)
  Ratio (95% CI) of days hospitalized
Recipient Factors Without DGF With DGF
Age (≥65 vs. <65) 1.10 (1.08-1.13) 1.11 (1.08-1.13)
Female 1.03 (1.01-1.04) 1.05 (1.03-1.06)
African American race 1.06 (1.04-1.08) 1.04 (1.02-1.06)
BMI (kg/m2)    
<18.5 1.09 (1.01-1.17) 1.09 (1.01-1.16)
18.5-24 1 1
25-29 0.99 (0.97-1.01) 0.98 (0.96-1.00)
29-34 1.00 (0.98-1.03) 0.97 (0.95-1.00)
≥35 1.03 (1.00-1.06) 0.98 (0.96-1.01)
Peak PRA >80 1.04 (1.02-1.06) 1.06 (1.02-1.10)
Diabetes 1.04 (1.02-1.06) 1.03 (1.01-1.04)
Years on dialysis    
0 (preemptive KT) 1 1
0-1 1.05 (1.02-1.09) 1.02 (0.99-1.05)
1-2 1.14 (1.10-1.17) 1.08 (1.05-1.11)
2-3 1.20 (1.16-1.24) 1.12 (1.08-1.16)
>3 1.29 (1.25-1.33) 1.16 (1.13-1.20)
KT factors    
0 HLA mismatches 0.97 (0.94-1.00) 0.99 (0.95-1.02)
CIT (hours)    
≤12 1 1
12-23 1.07 (1.04-1.09) 1.04 (1.02-1.06)
24-36 1.10 (1.07-1.13) 1.03 (1.00-1.06)
Thymoglobulin as induction agent 1.06 (1.04-1.08) 1.04 (1.02-1.05)
DGF – 1.65 (1.62-1.69)
Donor factors    
Live donor KT 1 1
Deceased standard criteria 1.10 (1.07-1.13) 1.05 (1.02-1.07)
DCD 1.21 (1.17-1.25) 1.06 (1.02-1.09)
ECD 1.17 (1.13-1.21) 1.07 (1.04-1.11)
Age (≥65 vs. <65) 1.00 (0.96-1.04) 1.00 (0.96-1.04)
Black race 0.97 (0.94-0.99) 0.98 (0.96-1.00)
In our single-center cohort frail KT recipients were twice as likely to have a LOS>2 weeks (65.7% vs. 34.3%; P=0.005). After accounting for all the confounders from the registry-based model, frailty was associated with a higher ratio of days hospitalized even after accounting for DGF (1.15 95%CI: 1.02-1.29; P=0.02).

CONCLUSIONS: Frailty is a novel predictor of KT LOS even after accounting for all registry-based predictors.

To cite this abstract in AMA style:

DeMarco MMcAdams, King E, Luo X, Kucirka L, Desai N, Dagher N, Lonze B, Montgomery R, Segev D. Frailty and Length of Stay in KT Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/frailty-and-length-of-stay-in-kt-recipients/. Accessed November 23, 2024.

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