BACKGROUND: Early hospital readmission (EHR) after kidney transplantation (KT) is associated with increased morbidity, transplant costs, and risk of transition-of-care errors. Registry-based recipient, transplant, and center-level predictors of EHR are limited, and novel predictors are needed. We hypothesized that frailty, a measure of physiologic reserve initially described and validated in geriatrics, might serve as a novel, independent predictor of EHR in KT recipients of all ages.
METHODS: We measured frailty (shrinking, weakness, exhaustion, low activity, and slowed walking speed) and other conventional (registry-based) factors in 446 KT recipients at Johns Hopkins Hospital at admission for KT. EHR was ascertained from medical records as ≥1 hospitalization within 30 days of initial post-KT discharge. The association between frailty and EHR was evaluated using modified Poisson regression adjusted for donor and recipient factors based on our previously published registry-based model.
RESULTS: 30.9% of KT recipients were readmitted within 30 days of initial discharge and 18.4% of the recipients were frail at KT. 21.1% of KT recipients were aged≥65. KT recipients who were frail at KT were more likely to experience EHR (46.3% vs. 27.5%, P =0.001). EHR was higher for those who were frail, regardless their age; interestingly, frail younger recipients even had higher EHR than nonfrail older recipients (45.5% vs. 35.3%, P=0.006).
Frailty was an independent predictor of EHR (RR=1.56, 95%CI: 1.17-2.07, P=0.002) in KT recipients. The association of frailty and EHR did not differ between older and younger KT recipients (Interaction P=0.32).
CONCLUSION: Frailty is an independent predictor for EHR following KT in recipients of all ages. Identifying frail KT recipients for targeted outpatient monitoring may reduce EHR rates.
To cite this abstract in AMA style:McAdams-DeMarco M, Law A, Salter M, Walston J, Segev D. Frailty and Early Hospital Readmission after Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/frailty-and-early-hospital-readmission-after-kidney-transplantation/. Accessed January 22, 2021.
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