Volume 9, Issue 2 (Spring 2021)                   Iran J Health Sci 2021, 9(2): 1-8 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Tavakkoli M, Yarahmadi A, Ghorban Sabbagh M, Najaf Najafi M, Tavakoli M, Soltani S. Assessment of Risk Factors for Hospital Readmission after Kidney Transplantation. Iran J Health Sci 2021; 9 (2) :1-8
URL: http://jhs.mazums.ac.ir/article-1-743-en.html
Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran , SoltaniS@mums.ac.ir
Abstract:   (1011 Views)

Background and Purpose: Hospital readmission after kidney transplantation is a real challenge for both patients and healthcare systems. Assessment of the risk factors of readmission after kidney transplantation is vital and can reduce morbidity and cost in transplant recipients and donors. The aim of the current study was to determine the risk factors of hospital readmission in patients undergoing kidney transplantation in Montaserieh Hospital of Mashhad, northeast of Iran.
Methods: This retrospective study included 523 first kidney transplant patients between January 2013 and March 2019 from the Montaserieh Hospital Information System (HIS) of Mashhad, Iran. Every-time readmission was the study primary outcome. Donors and recipient's demographic data, recipient's comorbidities, reasons for end-stage renal disease (ESRD), panel reactive antibody (PRA) status, dialysis parameters, cold ischemic time, and delayed graft function (DGF) were the potential risk factors. Statistical analysis was done using chi-square and Student's t-test.
Results: Data from 523 patients were assessed for potential eligibility. Based on the exclusion criteria, data from 479 patients were included in the final analysis. 174 (36.3%) patients were never readmitted, and 305 (63.7%) were readmitted at least once post-discharge. 39 (12.8%) were readmitted within the first month post-discharge. Older age, sex, higher prevalence of comorbidities, diabetes and hypertension, duration of primary disease before transplantation, hemodialysis and duration of pre-transplant dialysis, mean pre-transplant platelet count, intraoperative complications, increased cold ischemic time, and delayed graft function was associated with a higher prevalence of readmission (p < 0.05).
Conclusion: Our results showed that different independent variables and patients' comorbidities were important risk factors for readmission after kidney transplantation. Early prediction of these risk factors could result in the prevention of readmission in patients undergoing kidney transplantation.
Full-Text [PDF 408 kb]   (444 Downloads)    
Type of Study: Original Article | Subject: Health care Management

1. McAdams‐DeMarco M, Grams M, Hall E, Coresh J, Segev D. Early hospital readmission after kidney transplantation: patient and center‐level associations. American Journal of Transplantation. 2012;12(12):3283-8. [DOI:10.1111/j.1600-6143.2012.04285.x] [PMID]
2. Yarahmadi A, Shahrokhi SZ, Mostafavi-Pour Z, Azarpira N. MicroRNAs in Diabetic Nephropathy: From Molecular Mechanisms to New Therapeutic Targets of Treatment. Biochemical Pharmacology. 2020:114301. [DOI:10.1016/j.bcp.2020.114301] [PMID]
3. Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M, et al. Risk prediction models for hospital readmission: a systematic review. Jama. 2011;306(15):1688-98. [DOI:10.1001/jama.2011.1515] [PMID] [PMCID]
4. Kaplan B, Sweeney J. Assessing 30‐Day hospital readmission after renal transplantation: a complex task. American Journal of Transplantation. 2012;12(12):3171-2. [DOI:10.1111/j.1600-6143.2012.04289.x] [PMID]
5. Leppin AL, Gionfriddo MR, Kessler M, Brito JP, Mair FS, Gallacher K, et al. Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials. JAMA internal medicine. 2014;174(7):1095-107. [DOI:10.1001/jamainternmed.2014.1608] [PMID] [PMCID]
6. Englesbe M, Dimick J, Fan Z, Baser O, Birkmeyer J. Case mix, quality and high‐cost kidney transplant patients. American Journal of Transplantation. 2009;9(5):1108-14. [DOI:10.1111/j.1600-6143.2009.02592.x] [PMID] [PMCID]
7. Luan F, Barrantes F, Roth R, Samaniego M. Early hospital readmissions post‐kidney transplantation are associated with inferior clinical outcomes. Clinical transplantation. 2014;28(4):487-93. [DOI:10.1111/ctr.12347] [PMID]
8. McAdams‐DeMarco MA, Grams ME, King E, Desai NM, Segev DL. Sequelae of early hospital readmission after kidney transplantation. American Journal of Transplantation. 2014;14(2):397-403. [DOI:10.1111/ajt.12563] [PMID] [PMCID]
9. Hogan J, Arenson MD, Adhikary SM, Li K, Zhang X, Zhang R, et al. Assessing predictors of early and late hospital readmission after kidney transplantation. Transplantation direct. 2019;5(8). [DOI:10.1097/TXD.0000000000000918] [PMID] [PMCID]
10. Harhay M, Lin E, Pai A, Harhay M, Huverserian A, Mussell A, et al. Early rehospitalization after kidney transplantation: assessing preventability and prognosis. American Journal of Transplantation. 2013;13(12):3164-72. [DOI:10.1111/ajt.12513] [PMID] [PMCID]
11. Jones CE, Hollis RH, Wahl TS, Oriel BS, Itani KM, Morris MS, et al. Transitional care interventions and hospital readmissions in surgical populations: a systematic review. The American Journal of Surgery. 2016;212(2):327-35. [DOI:10.1016/j.amjsurg.2016.04.004] [PMID]
12. Dharnidharka VR, Stablein DM, Harmon WE. Post‐Transplant Infections Now Exceed Acute Rejection as Cause for Hospitalization: A Report of the NAPRTCS 1. American Journal of Transplantation. 2004;4(3):384-9. [DOI:10.1111/j.1600-6143.2004.00350.x] [PMID]
13. Haugen CE, King EA, Bae S, Bowring MG, Holscher CM, Garonzik-Wang J, et al. Early hospital readmission in older and younger kidney transplant recipients. American journal of nephrology. 2018;48(4):235-41. [DOI:10.1159/000492338] [PMID] [PMCID]
14. McAdams‐DeMarco MA, Law A, Salter ML, Chow E, Grams M, Walston J, et al. Frailty and early hospital readmission after kidney transplantation. American journal of transplantation. 2013;13(8):2091-5. [DOI:10.1111/ajt.12300] [PMID] [PMCID]
15. Taber DJ, Palanisamy AP, Srinivas TR, Gebregziabher M, Odeghe J, Chavin KD, et al. Inclusion of dynamic clinical data improves the predictive performance of a 30-day readmission risk model in kidney transplantation. Transplantation. 2015;99 (2): 324. [DOI:10.1097/TP.0000000000000565] [PMID] [PMCID]
16. Kim SH, Baird GL, Bayliss G, Merhi B, Osband A, Gohh R, et al. A single‐center analysis of early readmission after renal transplantation. Clinical transplantation. 2019;33(5):e13520. [DOI:10.1111/ctr.13520] [PMID]
17. Covert KL, Fleming JN, Staino C, Casale JP, Boyle KM, Pilch NA, et al. Predicting and preventing readmissions in kidney transplant recipients. Clinical transplantation. 2016;30(7):779-86. [DOI:10.1111/ctr.12748] [PMID]
18. Srinivas T, Taber D, Su Z, Zhang J, Mour G, Northrup D, et al. Big data, predictive analytics, and quality improvement in kidney transplantation: a proof of concept. American Journal of Transplantation. 2017;17(3):671-81. [DOI:10.1111/ajt.14099] [PMID]
19. Tsai TC, Joynt KE, Orav EJ, Gawande AA, Jha AK. Variation in surgical-readmission rates and quality of hospital care. New England Journal of Medicine. 2013;369(12):1134-42. [DOI:10.1056/NEJMsa1303118] [PMID] [PMCID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2023 CC BY-NC 4.0 | Iranian Journal of Health Sciences

Designed & Developed by : Yektaweb