@article{a1d8c9ccf11f438ab9bf7d28f36e9c3f,
title = "The association of discharge decisions after deceased donor kidney transplantation with the risk of early readmission: Results from the deceased donor study",
abstract = "Background: Kidney transplant (KT) recipients experience high rates of early (≤30 days) hospital readmission (EHR) after KT, and existing studies provide limited data on modifiable discharge factors that may mitigate EHR risk. Methods: We performed a retrospective cohort study of 468 adult deceased donor KT recipients transplanted between 4/2010 and 11/2013 at 5 United States transplant centers. We fit multivariable mixed effects models to assess the association of two potentially modifiable discharge factors with the probability of EHR after KT: (i) weekend discharge and (ii) days to first scheduled follow-up. Results: Among 468 KT recipients, 38% (n = 178) experienced EHR after KT. In fully adjusted analyses, compared to weekday discharges, KT recipients discharged on the weekend had a 29% lower risk of EHR (adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.41-0.94). Compared to follow-up within 2 days of discharge, KT recipients with follow-up within 3 to 6 days had a 28% higher probability of EHR (aOR 1.28, 95% CI 1.13-1.45). Conclusions: These findings suggest that clinical decisions related to the timing of discharge and follow-up modify EHR risk after KT, independent of traditional risk factors.",
keywords = "hospitalization, kidney, readmission",
author = "Harhay, {Meera Nair} and Yaqi Jia and Heather Thiessen-Philbrook and Behdad Besharatian and Ramnika Gumber and Weng, {Francis L.} and Hall, {Isaac E.} and Mona Doshi and Bernd Schroppel and Parikh, {Chirag R.} and Reese, {Peter P.}",
note = "Funding Information: M.N.H. is supported by K23DK105207 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This work was supported by National Institutes of Health Grants R01DK-93770 and K24DK090203, a Roche Organ Transplantation Research Foundation Award (to C.R.P.), an award from the American Heart Association (to I.E.H.), and Health Resources and Services Administration Contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. These organizations were not involved in study design, analysis, interpretation, or manuscript creation. The data reported here have been supplied by the United Network for Organ Sharing as the contractor for the OPTN. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the OPTN or the U.S. Government. Funding Information: National Institute of Diabetes and Digestive and Kidney Diseases, Grant/Award Number: K23DK105207, K24DK090203 and R01DK93770; American Heart Association; Health Resources and Services Administration, Grant/Award Number: Contract 234-2005-37011C; Roche Organ Transplant Research Foundation Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2018",
month = apr,
doi = "10.1111/ctr.13215",
language = "English (US)",
volume = "32",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "4",
}