Socioeconomic Factors and Early Hospital Readmission After Kidney Transplant at a Single Center
Department of Surgery, Johns Hopkins School of Medicine, Baltimore.
Meeting: 2015 American Transplant Congress
Abstract number: C60
Keywords: Economics, Kidney transplantation, Outcome, Post-operative complications
Session Information
Session Name: Poster Session C: Hospitalization/Readmission
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Early hospital readmission (EHR) is a key negative outcome in kidney transplantation (KT). Socioeconomic (SE) factors are associated with EHR in other contexts, but have not been fully explored in EHR after KT.
METHODS: We studied the association between EHR and demographic, SE, and clinical factors in 227 KT patients at our center from 2012-13. SE factors were: marriage, number of caregivers, drive time to center, education, financial concerns, fixed income, and insurance coverage. Variables were tested univariately for association with EHR using χ² and t-tests. Variables with p<0.1 were included in a multivariate logistic regression model.
RESULTS: EHR rate was 73/227 (32%). Univariate results are summarized in Table 1. SE factors were not associated with EHR; two clinical factors were: longer length of stay (LOS) (16.2 vs 10.8 d, p<0.01) and higher rate of prior transplant (29% vs 13%, p<0.01). Patients with EHR trended toward more caregivers (2.2 vs 1.9, p=0.08, counterintuitively), older age (54.2 vs 50.5 y, p=0.09), and more dialysis years (7.9 vs 2.0, p=0.06). Variables with higher rates but non-significant p-values in EHR patients were: high school or less education, Hepatitis C virus infection (HCV), and history of intravenous drug use (IVDU). A multivariate model of EHR using variables with p<0.1 association is summarized in Table 2. Number of caregivers was not significant with odds ratio (OR) 95% confidence interval (CI) 0.9281.2531.692. Older age had a significant OR 95% CI 1.0031.3081.705 (p=0.048).
CONCLUSION: There was no evidence of association between socioeconomic factors and EHR at our center.
| Variable | EHR | No EHR | p |
| Age | 54.2 | 50.5 | 0.09 |
| Gender (% F) | 47% | 44% | 0.8 |
| Race (% white) | 58% | 49% | 0.3 |
| Married | 59% | 61% | 0.9 |
| Caregivers (#) | 2.2 | 1.9 | 0.08 |
| Drive time to center (min) | 67 | 65 | 0.8 |
| High school educated or less | 8% | 4% | 0.4 |
| Financial concerns | 18% | 18% | 1.0 |
| Fixed income | 36% | 38% | 0.9 |
| Double insurance coverage | 56% | 57% | 1.0 |
| Dialysis years | 7.9 | 2.0 | 0.06 |
| Deceased donor | 59% | 58% | 1.0 |
| Discharge Cr | 2.59 | 2.81 | 0.5 |
| LOS (d) | 16.2 | 10.8 | <0.01 |
| Prior transplant | 29% | 13% | <0.01 |
| Anti-hypertension drugs (#) | 2.3 | 2.2 | 0.6 |
| Insulin | 19% | 13% | 0.3 |
| HCV | 14% | 7% | 0.2 |
| IVDU | 7% | 2% | 0.1 |
| Ever smoker | 45% | 34% | 0.2 |
| Mental health history | 32% | 26% | 0.4 |
| Variables | OR 95% CI | p |
| Caregivers | 0.9281.2531.692 | 0.1 |
| Age (per 10y) | 1.0031.3081.705 | 0.048 |
| LOS (per 10d) | 0.9531.4632.247 | 0.08 |
| Prior transplant | 0.7731.9745.039 | 0.2 |
| Dialysis years | 0.9781.0841.203 | 0.1 |
To cite this abstract in AMA style:
Lin J, King E, Craig-Shapiro R, Wickliffe C, Massie A, Segev D. Socioeconomic Factors and Early Hospital Readmission After Kidney Transplant at a Single Center [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/socioeconomic-factors-and-early-hospital-readmission-after-kidney-transplant-at-a-single-center/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress