Predicting and preventing readmissions in kidney transplant recipients.

Abstract:

:A lack of research exploring post-transplant process optimization to reduce readmissions and increasing readmission rates at our center from 2009 to 2013 led to this study, aimed at assessing the effect of patient and process factors on 30-d readmission rates after kidney transplantation. This was a retrospective case-control study in adult kidney transplant recipients. Univariate and multivariate analyses were utilized to assess patient and process determinants of 30-d readmissions. 384 patients were included; 30-d readmissions were significantly associated with graft loss and death (p = 0.001). Diabetes (p = 0.049), pharmacist identification of poor understanding or adherence, and prolonged time on hemodialysis prior to transplant were associated with an increased risk of 30-d readmissions. After controlling for risk factors, readmission rates were only independently predicted by pharmacist identification of patient lack of understanding or adherence regarding post-transplant medications and dialysis exposure for more than three yr (OR 2.3, 95% CI 1.10-4.71, p = 0.026 and OR 2.1, 95% CI 1.22, 3.70, respectively), both of which were significantly modified by history of diabetes. Thirty-d readmissions are attributable to both patient and process-level factors. These data suggest that a lack of post-transplant medication knowledge in high-risk patients drives early hospital readmission.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Covert KL,Fleming JN,Staino C,Casale JP,Boyle KM,Pilch NA,Meadows HB,Mardis CR,McGillicuddy JW,Nadig S,Bratton CF,Chavin KD,Baliga PK,Taber DJ

doi

10.1111/ctr.12748

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

779-86

issue

7

eissn

0902-0063

issn

1399-0012

journal_volume

30

pub_type

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