Assessment of risk factors for hospital readmission after kidney transplantation

Mahmoud  Tavakkoli; Amir  Yarahmadi; Mahin   Ghorban Sabbagh; Mona   Najaf Najafi; Milad   Tavakoli; Salman  Soltani

doi:10.18502/jhs.v9i2.6565

Mahmoud Tavakkoli Assistant Professor, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Amir Yarahmadi Instructor, Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mahin Ghorban Sabbagh Assistant Professor, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Mona Najaf Najafi Assistant Professor, Clinical Research Units, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Milad Tavakoli Medicine Student, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Salman Soltani Assistant Professor, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/jhs.v9i2.6565

Keywords: Kidney transplantation; Readmission; Risk Factors; Comorbidity

Abstract

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.

Materials and 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 were 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 prevention from readmission in patients undergoing kidney transplantation.