Assessment of Risk Factors for Hospital Readmission after Kidney Transplantation

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 ۵۲۳ first kidney transplant patients between January ۲۰۱۳ and March ۲۰۱۹ 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 ۵۲۳ patients were assessed for potential eligibility. Based on the exclusion criteria, data from ۴۷۹ patients were included in the final analysis. ۱۷۴ (۳۶.۳%) patients were never readmitted, and ۳۰۵ (۶۳.۷%) were readmitted at least once post-discharge. ۳۹ (۱۲.۸%) 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 < ۰.۰۵). 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.

Keywords:

Kidney transplantation ,  Readmission ,  Risk factors ,  Comorbidity