Risk factors for first-year hospital readmission after liver transplantation

被引:23
作者
Chen, Peixian [1 ]
Wang, Wentao [1 ]
Yan, Lunan [1 ]
Yang, Jiayin [1 ]
Wen, Tianfu [1 ]
Li, Bo [1 ]
Zhao, Jichun [2 ]
Xu, Mingqing [1 ]
机构
[1] Sichuan Univ, Dept Liver Surg, West China Hosp, Chengdu 610041, Sichuan Provinc, Peoples R China
[2] Sichuan Univ, Dept Vasc Surg, West China Hosp, Chengdu 610041, Sichuan Provinc, Peoples R China
关键词
liver transplantation; readmission; rehospitalization; risk factors; surgical procedure; INTENSIVE-CARE-UNIT; KIDNEY-TRANSPLANTATION; RENAL-TRANSPLANTATION; UNPLANNED READMISSION; COMPLICATIONS; REHOSPITALIZATION; OUTCOMES; PREDICTION; SURVIVAL; DISEASE;
D O I
10.1097/MEG.0000000000000327
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective To investigate the frequency of and the risk factors for hospital readmission within the first year after liver transplantation (LT). Materials and methods Between January 1999 and August 2013, LTs were performed in 890 adult patients at our center. We collected medical data from the Chinese Liver Transplant Registry and performed a retrospective review of the medical records of these patients. We aimed to identify the factors that contribute toward readmission during the first year after LT. We also first investigated the relationship between the number and severity of post-transplant complications and the risk of readmission. The survival outcomes of patients with and without readmission were also studied. Results A total of 165 rehospitalizations occurred in 142 patients (18.0%) within 1 year after discharge from their index admissions. The risk factors included hepatic malignancy as an indication for LT (P=0.01), previous abdominal surgery (P=0.03), the occurrence of any complications (P<0.001), biliary complications (P<0.001), vascular complications (P=0.005), rejection (P<0.001), pulmonary complications (P<0.001), infection (P<0.001), returning to the operating room (P<0.001), and other complications (P<0.001). First-year readmission rates increased as the number (P<0.01) and severity (P<0.01) of post-LT complications increased. Patients requiring readmission had decreased survival compared with those not requiring readmission during the first year of discharge after LT (P<0.001). Conclusion Our study identified the factors that place LT recipients at a high risk for readmission. This knowledge could help prevent and minimize rehospitalizations during the first year after LT. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.
引用
收藏
页码:600 / 606
页数:7
相关论文
共 42 条
[1]   Analysis of Liver Transplant Outcomes for United Network for Organ Sharing Recipients 60 Years Old or Older Identifies Multiple Model for End-Stage Liver Disease-Independent Prognostic Factors [J].
Aloia, Thomas A. ;
Knight, Richard ;
Gaber, A. Osama ;
Ghobrial, R. Mark ;
Goss, John A. .
LIVER TRANSPLANTATION, 2010, 16 (08) :950-959
[2]   Postdischarge environmental and socioeconomic factors and the likelihood of early hospital readmission among community-dwelling medicare beneficiaries [J].
Arbaje, Alicia I. ;
Wolff, Jennifer L. ;
Yu, Qilu ;
Powe, Neil R. ;
Anderson, Gerard F. ;
Boult, Chad .
GERONTOLOGIST, 2008, 48 (04) :495-504
[3]   Risk Factors for 30-Day Hospital Readmission following Myeloablative Allogeneic Hematopoietic Cell Transplantation (allo-HCT) [J].
Bejanyan, Nelli ;
Bolwell, Brian J. ;
Lazaryan, Aleksandr ;
Rybicki, Lisa ;
Tench, Shawnda ;
Duong, Hien ;
Andresen, Steven ;
Sobecks, Ronald ;
Dean, Robert ;
Pohlman, Brad ;
Kalaycio, Matt ;
Copelan, Edward A. .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2012, 18 (06) :874-880
[4]   Rehospitalization After Kidney Transplantation During the First Year: Length, Causes and Relationship With Long-term Patient and Graft Survival [J].
Boubaker, K. ;
Harzallah, A. ;
Ounissi, M. ;
Becha, M. ;
Guergueh, T. ;
Hedri, H. ;
Kaaroud, H. ;
Abderrahim, E. ;
Ben Abdellah, T. ;
Kheder, A. .
TRANSPLANTATION PROCEEDINGS, 2011, 43 (05) :1742-1746
[5]  
Cheadle William G, 2006, Surg Infect (Larchmt), V7 Suppl 1, pS7, DOI 10.1089/sur.2006.7.s-7
[6]  
Chen PX, 2014, ANN TRANSPL, V19, P13, DOI 10.12659/AOT.889735
[7]   Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report [J].
Clavien, Pierre-Alain ;
Lesurtel, Mickael ;
Bossuyt, Patrick M. M. ;
Gores, Gregory J. ;
Langer, Bernard ;
Perrier, Arnaud .
LANCET ONCOLOGY, 2012, 13 (01) :E11-E22
[8]   Improving the quality of transitional care for persons with complex care needs [J].
Coleman, EA ;
Boult, C .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (04) :556-557
[9]   Posthospital care transitions: Patterns, complications, and risk identification [J].
Coleman, EA ;
Min, SJ ;
Chomiak, A ;
Kramer, AM .
HEALTH SERVICES RESEARCH, 2004, 39 (05) :1449-1465
[10]   Lost in transition: Challenges and opportunities for improving the quality of transitional care [J].
Coleman, EA ;
Berenson, RA .
ANNALS OF INTERNAL MEDICINE, 2004, 141 (07) :533-535