Nguyen Michelle C, Avila Christina L, Brock Guy N, Benedict Jason A, James Iyore, El-Hinnawi Ashraf, Rajab Amer, Elkhammas Elmahdi, Pelletier Ronald P, Henry Mitchell, Bumgardner Ginny L
Division of Transplant Surgery and Comprehensive Transplant Center, Department of Surgery, The Ohio State University, Columbus, Ohio.
Medical Student Research Program, The Ohio State University College of Medicine, Columbus, Ohio.
Clin Transplant. 2020 Mar;34(3):e13822. doi: 10.1111/ctr.13822. Epub 2020 Mar 2.
Hospital readmission (HR) after surgery is considered a quality metric.
Data on 2371 first-time adult kidney transplant (KT) recipients were collected to analyze the "early" (≤30 days) and "late" (31-365 days) HR patterns after KT at a single center over a 12-year time span (2002-2013).
30-day, 90-day, and 1-year HR were 31%, 41%, and 53%, respectively. Risk factors for HR included age >50, female sex, black race, BMI >30, transplant LOS >5 days, and pre-transplant time on dialysis >765 days. Indications for early (n = 749) and late (n = 508) HR were similar. Early HR (OR: 3.80, P = .007) and black race (OR: 2.38, P = .009) were associated with higher odds of 1-year graft failure while frequency (1-2, 3-4, 5+) of HR (ORs: 4.68, 8.36, 9.44, P < .001) and age > 50 (OR: 2.11, P = .007) were associated with higher odds of 1-year mortality. Transplant LOS > 5 days increased both odds of 1-year graft failure (OR: 3.51, P = .001) and mortality (OR: 2.05, P = .006). One-year graft and recipient survival were 96.7% and 94.8%, respectively.
Hospital readmission was associated with reduced graft and patient survival; however, despite a relatively high and consistent HR rate after KT, overall 1-year graft and patient survival was high.
手术后的医院再入院（HR）被视为一项质量指标。
收集了2371例首次接受成人肾移植（KT）受者的数据，以分析在一个单一中心12年时间跨度（2002 - 2013年）内KT术后“早期”（≤30天）和“晚期”（31 - 365天）的HR模式。
30天、90天和1年的HR分别为31%、41%和53%。HR的危险因素包括年龄>50岁、女性、黑人种族（非裔美国人）、BMI>30、移植住院时间>5天以及移植前透析时间>765天。早期（n = 749）和晚期（n = 508）HR的指征相似。早期HR（比值比：3.80，P = 0.007）和黑人种族（比值比：2.38，P = 0.009）与1年移植失败几率较高相关，而HR的频率（1 - 2次、3 - 4次、5次以上）（比值比：4.68、8.36、9.44，P < 0.001）和年龄>50岁（比值比：2.11，P = 0.007）与1年死亡率几率较高相关。移植住院时间>5天增加了1年移植失败几率（比值比：3.51，P = 0.001）和死亡率（比值比：2.05，P = 0.006）。1年移植和受者生存率分别为96.7%和94.8%。
医院再入院与移植和患者生存率降低相关；然而，尽管KT术后HR率相对较高且较为一致，但总体1年移植和患者生存率较高。
