TY - JOUR
T1 - Burden And Correlates Of Hospital Readmissions Among U.S. Peritoneal Dialysis Patients
AU - Sahlie, Abyalew
AU - Jaar, Bernard G.
AU - Paez, Lilian Galarza
AU - Masud, Tahsin
AU - Lea, Janice P.
AU - Burkart, John M.
AU - Plantinga, Laura C.
N1 - Funding Information:
The data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the U.S. government. This work was presented in part at the National Kidney Foundation 2018 Spring Clinical Meetings, held in Austin, Texas, April 10 ? 14, 2018. This project was supported by grant number R03HS025018 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Funding Information:
The data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the U.S. government. This work was presented in part at the National Kidney Foundation 2018 Spring Clinical Meetings, held in Austin, Texas, April 10 – 14, 2018. This project was supported by grant number R03HS025018 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Publisher Copyright:
© 2019 International Society for Peritoneal Dialysis. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: Hospital readmissions are common among in-center hemodialysis patients, but little is known about readmissions among peritoneal dialysis (PD) patients. Using national administrative data, we aimed to examine the burden and correlates of hospital readmissions among U.S. PD patients. Methods: Among 10,505 adult U.S. PD patients with an index admission (first admission after 120 days on dialysis) between 31January 2011 and 30 November 2014, readmissions were defined as new hospital admissions within 30 days of index discharge. Multivariable logistic regression was used to obtain adjusted odds ratios (ORs) for readmission. Results: Overall, 26.8% of index admissions were followed by a readmission. Readmitted patients were more likely to have congestive heart failure (31.0% vs 25.4%; p < 0.001) and peripheral arterial disease (11.6% vs 8.6%; p < 0.001) and had longer index admission length of stay (median = 4 vs 3 days; p < 0.001) than those who were not; age, sex, and race did not differ by readmission status. After adjustment for patient and index admission characteristics, longer length of stay (≥ 4 vs < 4 days, OR = 1.48, 95% confidence interval [CI] 1.35 – 1.62), peripheral arterial disease (OR = 1.31, 95% CI 1.16 – 1.57), congestive heart failure (OR = 1.25, 95% CI 1.13 – 1.39), and ischemic heart disease (OR= 1.12, 95% CI 1.01 – 1.24) were associated with higher likelihood of readmission; index admission due to peritonitis vs other causes was associated with lower likelihood of readmission (OR = 0.80, 95% CI 0.70 – 0.92). Conclusions: Our results suggest that, particularly in the absence of a PD-related cause of hospitalization such as peritonitis, PD patients may be at high risk for readmission and may benefit from closer post-discharge monitoring.
AB - Background: Hospital readmissions are common among in-center hemodialysis patients, but little is known about readmissions among peritoneal dialysis (PD) patients. Using national administrative data, we aimed to examine the burden and correlates of hospital readmissions among U.S. PD patients. Methods: Among 10,505 adult U.S. PD patients with an index admission (first admission after 120 days on dialysis) between 31January 2011 and 30 November 2014, readmissions were defined as new hospital admissions within 30 days of index discharge. Multivariable logistic regression was used to obtain adjusted odds ratios (ORs) for readmission. Results: Overall, 26.8% of index admissions were followed by a readmission. Readmitted patients were more likely to have congestive heart failure (31.0% vs 25.4%; p < 0.001) and peripheral arterial disease (11.6% vs 8.6%; p < 0.001) and had longer index admission length of stay (median = 4 vs 3 days; p < 0.001) than those who were not; age, sex, and race did not differ by readmission status. After adjustment for patient and index admission characteristics, longer length of stay (≥ 4 vs < 4 days, OR = 1.48, 95% confidence interval [CI] 1.35 – 1.62), peripheral arterial disease (OR = 1.31, 95% CI 1.16 – 1.57), congestive heart failure (OR = 1.25, 95% CI 1.13 – 1.39), and ischemic heart disease (OR= 1.12, 95% CI 1.01 – 1.24) were associated with higher likelihood of readmission; index admission due to peritonitis vs other causes was associated with lower likelihood of readmission (OR = 0.80, 95% CI 0.70 – 0.92). Conclusions: Our results suggest that, particularly in the absence of a PD-related cause of hospitalization such as peritonitis, PD patients may be at high risk for readmission and may benefit from closer post-discharge monitoring.
KW - Hospitalization
KW - prevalence
KW - risk factors
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UR - http://www.scopus.com/inward/citedby.url?scp=85066855031&partnerID=8YFLogxK
U2 - 10.3747/pdi.2018.00175
DO - 10.3747/pdi.2018.00175
M3 - Article
C2 - 30846608
AN - SCOPUS:85066855031
VL - 39
SP - 261
EP - 267
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
SN - 0896-8608
IS - 3
ER -