Michael O. Harhay|Elaina E. Lin|Amy Barton Pai|Michael O. Harhay|Ari Huverserian|Adam Mussell|Peter Abt|Matthew Levine|Roy D. Bloom|Judy A. Shea|Andrea B. Troxel|Peter P. Reese
Early Rehospitalization After Kidney Transplantation: Assessing Preventability and Prognosis
University of Pennsylvania|University of Pennsylvania|Pennsylvania Hospital|University of Pennsylvania|Washington University in St. Louis|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania
early rehospitalization kidney transplantation kt common may predict future adverse outcomes previous studies using claims data limited identifying preventable rehospitalizations assembled cohort 753 adults institution undergoing kt january 1 2003 december 31 2007 two physicians independently reviewed medical records 237 patients 32 early rehospitalization identified 1 primary reason 2 preventability rehospitalization mortality graft failure ascertained linkage scientific registry transplant recipients leading reasons rehospitalization included surgical complications 15 rejection 14 volume shifts 11 systemic surgical wound infections 11 25 reviewer agreement primary reason 85 cases strong kappa 078 19 rehospitalizations 8 met preventability criteria using logistic regression weekend discharge odds ratio 159 p 001 waitlist time 110 p 004 longer initial length stay 142 p 003 associated early rehospitalization using cox regression early rehospitalization associated mortality hazard ratio hr 155 p 003 graft loss hr 133 p 009 early rehospitalization diverse causes presents challenges quality metric kt results validated prospectively multiple centers identify vulnerable patients modifiable processesofcare