Readmission following liver transplantation: an unwanted occurrence but an opportunity to act

Madhukar S. Patel, Jahan Mohebali, Jigesh A. Shah, James F. Markmann, Parsia A. Vagefi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Liver transplant (LT) patients are at high risk for readmission. This study sought to identify predictors of readmission following liver transplantation and to evaluate their impact on survival in a region with prolonged waiting list times. Methods A single center review of adult deceased donor LT's from 2005 to 2015 was performed, with linkage to the UNOS Standard Transplant Analysis and Research registry. Readmission was defined as hospitalization within 90 days of discharge. Logistic regression was used to identify independent predictors of readmission and Kaplan–Meier analysis for survival. Results 325 patients underwent LT with an overall 90-day readmission rate of 46%. Upon adjusted analysis, predictors of readmission were age (OR 0.97 per year), male gender (OR 0.48), hospital length of stay (OR 1.03 per day), and hepatitis C liver failure (OR 2.37). Readmitted patients demonstrated a significantly lower 5-year survival (75% vs. 88%, p = 0.008) with only one patient (0.7%) dying during initial readmission. Conclusions Nearly half of all patients are readmitted after LT. As readmission portents decreased survival, an emphasis should be placed on identifying and optimizing those at increased risk. If readmission does occur, however, it presents an opportunity to intervene, as virtually no patients died during initial readmission.

Original languageEnglish (US)
Pages (from-to)936-942
Number of pages7
JournalHPB
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Liver Transplantation
Transplants
Survival
Liver
Length of Stay
Waiting Lists
Liver Failure
Survival Analysis
Hepatitis C
Registries
Hospitalization
Logistic Models
Tissue Donors
Research

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Readmission following liver transplantation : an unwanted occurrence but an opportunity to act. / Patel, Madhukar S.; Mohebali, Jahan; Shah, Jigesh A.; Markmann, James F.; Vagefi, Parsia A.

In: HPB, Vol. 18, No. 11, 01.11.2016, p. 936-942.

Research output: Contribution to journalArticle

Patel, Madhukar S. ; Mohebali, Jahan ; Shah, Jigesh A. ; Markmann, James F. ; Vagefi, Parsia A. / Readmission following liver transplantation : an unwanted occurrence but an opportunity to act. In: HPB. 2016 ; Vol. 18, No. 11. pp. 936-942.
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abstract = "Background Liver transplant (LT) patients are at high risk for readmission. This study sought to identify predictors of readmission following liver transplantation and to evaluate their impact on survival in a region with prolonged waiting list times. Methods A single center review of adult deceased donor LT's from 2005 to 2015 was performed, with linkage to the UNOS Standard Transplant Analysis and Research registry. Readmission was defined as hospitalization within 90 days of discharge. Logistic regression was used to identify independent predictors of readmission and Kaplan–Meier analysis for survival. Results 325 patients underwent LT with an overall 90-day readmission rate of 46{\%}. Upon adjusted analysis, predictors of readmission were age (OR 0.97 per year), male gender (OR 0.48), hospital length of stay (OR 1.03 per day), and hepatitis C liver failure (OR 2.37). Readmitted patients demonstrated a significantly lower 5-year survival (75{\%} vs. 88{\%}, p = 0.008) with only one patient (0.7{\%}) dying during initial readmission. Conclusions Nearly half of all patients are readmitted after LT. As readmission portents decreased survival, an emphasis should be placed on identifying and optimizing those at increased risk. If readmission does occur, however, it presents an opportunity to intervene, as virtually no patients died during initial readmission.",
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N2 - Background Liver transplant (LT) patients are at high risk for readmission. This study sought to identify predictors of readmission following liver transplantation and to evaluate their impact on survival in a region with prolonged waiting list times. Methods A single center review of adult deceased donor LT's from 2005 to 2015 was performed, with linkage to the UNOS Standard Transplant Analysis and Research registry. Readmission was defined as hospitalization within 90 days of discharge. Logistic regression was used to identify independent predictors of readmission and Kaplan–Meier analysis for survival. Results 325 patients underwent LT with an overall 90-day readmission rate of 46%. Upon adjusted analysis, predictors of readmission were age (OR 0.97 per year), male gender (OR 0.48), hospital length of stay (OR 1.03 per day), and hepatitis C liver failure (OR 2.37). Readmitted patients demonstrated a significantly lower 5-year survival (75% vs. 88%, p = 0.008) with only one patient (0.7%) dying during initial readmission. Conclusions Nearly half of all patients are readmitted after LT. As readmission portents decreased survival, an emphasis should be placed on identifying and optimizing those at increased risk. If readmission does occur, however, it presents an opportunity to intervene, as virtually no patients died during initial readmission.

AB - Background Liver transplant (LT) patients are at high risk for readmission. This study sought to identify predictors of readmission following liver transplantation and to evaluate their impact on survival in a region with prolonged waiting list times. Methods A single center review of adult deceased donor LT's from 2005 to 2015 was performed, with linkage to the UNOS Standard Transplant Analysis and Research registry. Readmission was defined as hospitalization within 90 days of discharge. Logistic regression was used to identify independent predictors of readmission and Kaplan–Meier analysis for survival. Results 325 patients underwent LT with an overall 90-day readmission rate of 46%. Upon adjusted analysis, predictors of readmission were age (OR 0.97 per year), male gender (OR 0.48), hospital length of stay (OR 1.03 per day), and hepatitis C liver failure (OR 2.37). Readmitted patients demonstrated a significantly lower 5-year survival (75% vs. 88%, p = 0.008) with only one patient (0.7%) dying during initial readmission. Conclusions Nearly half of all patients are readmitted after LT. As readmission portents decreased survival, an emphasis should be placed on identifying and optimizing those at increased risk. If readmission does occur, however, it presents an opportunity to intervene, as virtually no patients died during initial readmission.

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