TY - JOUR
T1 - Readmission following liver transplantation
T2 - an unwanted occurrence but an opportunity to act
AU - Patel, Madhukar S.
AU - Mohebali, Jahan
AU - Shah, Jigesh A.
AU - Markmann, James F.
AU - Vagefi, Parsia A.
N1 - Publisher Copyright:
© 2016 International Hepato-Pancreato-Biliary Association Inc.
PY - 2016/11/1
Y1 - 2016/11/1
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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U2 - 10.1016/j.hpb.2016.08.003
DO - 10.1016/j.hpb.2016.08.003
M3 - Article
C2 - 27642080
AN - SCOPUS:84992730351
SN - 1365-182X
VL - 18
SP - 936
EP - 942
JO - HPB
JF - HPB
IS - 11
ER -