Date: Monday, May 4, 2015
Session Name: Concurrent Session: Kidney: Hospitalization/Readmission
Session Time: 2:15pm-3:45pm
Presentation Time: 2:27pm-2:39pm
Location: Room 118-AB
Purpose: Readmissions are a major morbidity following kidney transplantation (KT). Prior studies report a 30-day readmission rate of 30%. Limited data exist on risk facotors and preventative stratigies for readmission. We reviewed 4 years of KT at our institution to identify incidence and risk factors for 30-day readmission. We evaluated our discharge (d/c) education protocol (DEP) as a strategy to prevent readmission.
Methods: Retrospective chart review of adult KT at Mt. Sinai between 2009 and 2013 was performed. Pts sent to a skilled facility, multi-organ transplants, primary non-function, and death before d/c were excluded. The following factors were assessed in relation to readmission: presence of diabetes (DM), gender, race, d/c yr, living vs deceased donor, delayed graft function (DGF), age and length of stay (LOS). We evaluated our DEP in preventing readmissions which includes 1:1 teaching, recipients attending a teaching class, and having support present for teaching. Chi-square test was used for categorical variables and the t-test and the Kruskal-Wallis test were used as appropriate for continuous variables. Multivariate logistic regression was performed to assess independent predictors of readmission.
Results: 681 patients meet study criteria of which 223 had a 30-day readmission (32.7%). Factors associated with readmission included DM status (52% vs 39%, p=0.002), LOS (6.2 va 5.1 days, p=0.006), ethnicity (p=0.024) and completing DEP (63% vs 91%, p<0.0001). DGF after KT and year of discharge (2009-2011 vs 2012) trended towards significance (p= 0.055; p=0.66 respectively). In the multivariate analysis the presence of DM increased odds of readmission while Asian ethnicity and completing DEP resulted in lower odds of readmission.
|Point estimate||95% CI|
|DM vs no DM||1.493||1.015||2.195|
|Race: Asian vs White||0.409||0.210||0.797|
|Black vs White||0.707||0.460||1.087|
|Hispanic vs White||0.678||0.408||1.126|
|Mid-East vs White||3.050||0.704||13.218|
|DEP met vs not met||0.164||0.104||0.258|
To cite this abstract in AMA style:Khaim R, Nair V. Predicting and Preventing 30-Day Readmission Following Kidney Transplantation: A Single Center Study [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/predicting-and-preventing-30-day-readmission-following-kidney-transplantation-a-single-center-study/. Accessed January 17, 2020.
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