There is an increased focus on hospital readmissions as a driver of health care costs and indicator of health care quality. Study Purpose: Understanding the incidence, patterns, risk factors and outcomes associated with hospital readmissions posttransplant may be useful to guide interventions. Methods: This retrospective study investigated incidence, risk factors and outcomes associated with readmissions in the first year posttransplant for all kidney transplant recipients at a single center between 1/4/02 to 1/1/14 (n=2,383). Patient demographics, distance from transplant center, medications, frequency and timing of readmission, rejection episodes, graft loss, and patient death were collected. Statistical Analysis: Univariable logistic regression was used to assess factors associated with dichotomous outcomes. (Stata version 14.1). Results: The patient population consisted of first time transplant recipients (91.0%), male (59.7%), English as a native language (78.4%), Caucasian (75.3%) and African-American (21.3%), diabetics (24.3%), and BMI of 30 or greater (40.5%). Over the study period there was a 36.1% (95% CI: 34.2-38.1%) 30-day readmission rate. Over the first year posttransplant 64.9% (95% CI: 62.6%-66.8%) of recipients required at least one readmission. Altogether 35.1, 23.0, 14.1, and 27.7 per cent of patients required 0, 1, 2, 3 or more readmissions in the first year posttransplant. The odds ratio of 3 or more readmissions within 1-year of transplant was 1.2% higher for every 1-year increase in age (OR=1.012, p<0.001) and 23.1% lower for males compared to females (OR=0.769, p=0.005). Other risk factors associated with increased readmission rates were: deceased donor organ (p=0.008), non-English speakers (p=0.073) and BMI (p<0.001). Readmissions were associated with increased rates of graft rejection (p<0.001) and graft loss (p<0.001); 3 or more admissions increased the OR of patient death between year 1 and 2 after transplant by 129% (OR=2.29, p=0.001). One-year graft survival rate was 96.7% (95% CI: 95.9%-97.4%) and patient survival rate was 94.8% (95% CI: 93.8%-95.7%) over the time span. In conclusion, excellent 1-year graft and patient survival rates can be achieved in the high risk demographic of patients with ESRD and are associated with significant inpatient care during the first year posttransplant. Further detailed analysis of the causes for readmission are needed to guide interventional strategies.

CITATION INFORMATION: Avila C, James I, Phillips G, El-Hinnawi A, Rajab A, Pelletier R, Henry M, Bumgardner G. Hospital Readmissions in the First Year Post Transplant Over a 12-Year Span at a Single Center. Am J Transplant. 2016;16 (suppl 3).

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