Kyla L Naylor1,2, Gregory A Knoll3, Britney Allen1, Alvin H Li4, Amit X Garg1,5,6, Ngan N Lam7, Megan K McCallum1, S Joseph Kim8. 1. Institute for Clinical Evaluative Sciences (ICES), Ontario, Canada. 2. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. 3. Division of Nephrology, Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada. 4. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 5. Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada. 6. Division of Nephrology, Western University, London, Ontario, Canada. 7. Division of Nephrology, University of Alberta, Edmonton, AB, Canada. 8. Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Early hospital readmission (EHR) is associated with morbidity, mortality, and significant healthcare costs. However, trends over time in EHR events in kidney transplant recipients have not been examined. We conducted a population-based cohort study using linked healthcare databases from Ontario, Canada, to determine whether the EHR incidence has changed from 2002 to 2014 in kidney transplant recipients. METHODS: We defined EHR as an unplanned admission for any reason to an acute care hospital within 30 days of being discharged from the hospital for transplantation; admissions for elective procedures were excluded. RESULTS: We included 5437 kidney transplant recipients. More recently transplanted recipients (2011 to 2014 vs 2002 to 2004) were older and more likely to have coronary artery disease. A total of 1128 (20.7%) kidney transplant recipients experienced an EHR. There was no trend in EHR across eras with a 30-day cumulative incidence of 23.0%, 21.4%, 18.4%, and 21.0% (P for trend =0.197) for the years 2002 to 2004, 2005 to 2007, 2008 to 2010, and 2011 to 2014, respectively. In the multivariable Cox proportional hazards model, we found no association between era of transplant and EHR. When examining variation in EHR across the 6 adult transplant centers, we found the 30-day cumulative incidence varied significantly from 15.5% to 27.1% (P < 0.001). CONCLUSIONS: One in 5 kidney transplant recipients will experience an EHR; however, an increase in EHR over time has not been observed despite increasing recipient age and comorbidities.
BACKGROUND: Early hospital readmission (EHR) is associated with morbidity, mortality, and significant healthcare costs. However, trends over time in EHR events in kidney transplant recipients have not been examined. We conducted a population-based cohort study using linked healthcare databases from Ontario, Canada, to determine whether the EHR incidence has changed from 2002 to 2014 in kidney transplant recipients. METHODS: We defined EHR as an unplanned admission for any reason to an acute care hospital within 30 days of being discharged from the hospital for transplantation; admissions for elective procedures were excluded. RESULTS: We included 5437 kidney transplant recipients. More recently transplanted recipients (2011 to 2014 vs 2002 to 2004) were older and more likely to have coronary artery disease. A total of 1128 (20.7%) kidney transplant recipients experienced an EHR. There was no trend in EHR across eras with a 30-day cumulative incidence of 23.0%, 21.4%, 18.4%, and 21.0% (P for trend =0.197) for the years 2002 to 2004, 2005 to 2007, 2008 to 2010, and 2011 to 2014, respectively. In the multivariable Cox proportional hazards model, we found no association between era of transplant and EHR. When examining variation in EHR across the 6 adult transplant centers, we found the 30-day cumulative incidence varied significantly from 15.5% to 27.1% (P < 0.001). CONCLUSIONS: One in 5 kidney transplant recipients will experience an EHR; however, an increase in EHR over time has not been observed despite increasing recipient age and comorbidities.
Authors: Sarah E Van Pilsum Rasmussen; Fatima Warsame; Ann K Eno; Hao Ying; Karina Covarrubias; Christine E Haugen; Nadia M Chu; Deidra C Crews; Meera N Harhay; Nancy L Schoenborn; Dorry L Segev; Mara A McAdams-DeMarco Journal: Transplantation Date: 2020-03 Impact factor: 5.385
Authors: Michelle C Nguyen; Christina L Avila; Guy N Brock; Jason A Benedict; Iyore James; Ashraf El-Hinnawi; Amer Rajab; Elmahdi Elkhammas; Ronald P Pelletier; Mitchell Henry; Ginny L Bumgardner Journal: Clin Transplant Date: 2020-03-02 Impact factor: 3.456
Authors: Julien Hogan; Michael D Arenson; Sandesh M Adhikary; Kevin Li; Xingyu Zhang; Rebecca Zhang; Jeffrey N Valdez; Raymond J Lynch; Jimeng Sun; Andrew B Adams; Rachel E Patzer Journal: Transplant Direct Date: 2019-07-29
Authors: Kyla L Naylor; Gregory A Knoll; Justin Slater; Eric McArthur; Amit X Garg; Ngan N Lam; Britney Le; Alvin H Li; Megan K McCallum; Marlee Vinegar; S Joseph Kim Journal: Can J Kidney Health Dis Date: 2021-11-29
Authors: Kyla L Naylor; S Joseph Kim; Eric McArthur; Amit X Garg; Marlee Vinegar; Megan K McCallum; Gregory A Knoll Journal: Can J Kidney Health Dis Date: 2021-11-10