Background: Hospital readmissions after kidney transplant have been associated with increased morbidity, mortality, decreased quality of life, and increased healthcare costs. The objective of this study was to identify clinical factors associated with 30-day hospital readmission post kidney transplant at an academic medical center. Methods: This study was a retrospective, single-center cohort study. A total of 224 patients were included who received a kidney transplant between July 1, 2014 and October 12, 2016. Patients were evaluated based on the 30-day hospital readmission post kidney transplant. Results: A total of 59 (26.3%) transplant recipients were readmitted within 30 days of discharge. Readmission rates did not differ between age, race, or initial hospital length of stay. Diabetes as the cause of ESRD and dialysis prior to transplant were associated with differences in 30-day readmission. Diabetes as the cause of ESRD was associated with a readmission rate of 35.7% compared to 22.1% in those without diabetes (p=0.032). Patients on dialysis prior to transplant had a readmission rate of 28.2% compared to those not on dialysis 5.6% (p=0.037). There was a trend towards lower readmission rates in living donor recipients versus cadaveric, but the difference was not statistically significant. There was a trend towards higher 30-day readmission rates for patients with history of CAD, delayed graft function, subtherapeutic tacrolimus level at discharge, level of education less than a college degree, treatment for donor positive culture and treatment for urinary tract infection within 30 days post-transplant; however these were not found to be statistically significant factors. Interestingly, patients discharged on the weekend had a lower 30-day readmission rate compared to those discharged on weekdays (16.7% v. 30.9%; p=0.024). Conclusions: In our population, diabetes as the cause of ESRD and dialysis prior to transplant had a statistically significant higher 30-day readmission rate. There was a trend towards higher readmission rates in patients with cadaveric transplant, history of CAD, delayed graft function, subtherapeutic tacrolimus level at discharge, level of education less than a college degree, treatment for donor positive culture and treatment for urinary tract infection. These factors may be beneficial areas of intervention to reduce readmission rates, improve patient outcomes, and reduce healthcare costs.

CITATION INFORMATION: Ostrem J, Brokhof M, Kenyon N, Hollinger E, Jensik S, Olaitan O, Hertl M, Alvey N. Factors Predicting 30-Day Hospital Readmission After Kidney Transplant. Am J Transplant. 2017;17 (suppl 3).

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