Early Hospital Readmission after Simultaneous Pancreas-Kidney Transplantation

Patient and Center-Level Factors

Research output: Contribution to journalArticle

Abstract

Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5%. Each decade increase in age was associated with an 11% lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13% higher risk of readmission. Each day increase in length of stay was associated with a 2% higher risk of readmission until 14 days, beyond which each day increase was associated with a 1% reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.

Original languageEnglish (US)
Pages (from-to)541-549
Number of pages9
JournalAmerican Journal of Transplantation
Volume16
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

Patient Readmission
Pancreas Transplantation
Kidney Transplantation
Kidney
Pancreas
Quality of Health Care
Incidence
Risk Reduction Behavior
Information Systems
African Americans
Length of Stay
Hospitalization
Tissue Donors
Morbidity
Transplants
Costs and Cost Analysis
Mortality

Keywords

  • clinical decision-making
  • clinical research/practice
  • health services and outcomes research
  • hospital readmission
  • pancreas/simultaneous pancreas-kidney transplantation
  • quality of care/care delivery

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

@article{fe3ddc05182f4bb9bd752c4edbf749ee,
title = "Early Hospital Readmission after Simultaneous Pancreas-Kidney Transplantation: Patient and Center-Level Factors",
abstract = "Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5{\%}. Each decade increase in age was associated with an 11{\%} lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13{\%} higher risk of readmission. Each day increase in length of stay was associated with a 2{\%} higher risk of readmission until 14 days, beyond which each day increase was associated with a 1{\%} reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.",
keywords = "clinical decision-making, clinical research/practice, health services and outcomes research, hospital readmission, pancreas/simultaneous pancreas-kidney transplantation, quality of care/care delivery",
author = "Elizabeth King and Kucirka, {L. M.} and {McAdams Demarco}, {Mara Ann} and Massie, {Allan B} and {Al Ammary}, Fawaz and R. Ahmed and Morgan Grams and Dorry Segev",
year = "2016",
month = "2",
day = "1",
doi = "10.1111/ajt.13485",
language = "English (US)",
volume = "16",
pages = "541--549",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Early Hospital Readmission after Simultaneous Pancreas-Kidney Transplantation

T2 - Patient and Center-Level Factors

AU - King, Elizabeth

AU - Kucirka, L. M.

AU - McAdams Demarco, Mara Ann

AU - Massie, Allan B

AU - Al Ammary, Fawaz

AU - Ahmed, R.

AU - Grams, Morgan

AU - Segev, Dorry

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5%. Each decade increase in age was associated with an 11% lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13% higher risk of readmission. Each day increase in length of stay was associated with a 2% higher risk of readmission until 14 days, beyond which each day increase was associated with a 1% reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.

AB - Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5%. Each decade increase in age was associated with an 11% lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13% higher risk of readmission. Each day increase in length of stay was associated with a 2% higher risk of readmission until 14 days, beyond which each day increase was associated with a 1% reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.

KW - clinical decision-making

KW - clinical research/practice

KW - health services and outcomes research

KW - hospital readmission

KW - pancreas/simultaneous pancreas-kidney transplantation

KW - quality of care/care delivery

UR - http://www.scopus.com/inward/record.url?scp=84957941167&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957941167&partnerID=8YFLogxK

U2 - 10.1111/ajt.13485

DO - 10.1111/ajt.13485

M3 - Article

VL - 16

SP - 541

EP - 549

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 2

ER -