Schucht Jessica, Davis Eric G, Jones Christopher M, Cannon Robert M
Am Surg. 2020 Feb 1;86(2):116-120.
Unplanned readmission is often used as a surgical quality metric. A subset of kidney transplant recipients undergos multiple readmissions (MRs), although the incidence and risk factors are not well described. The aim of this study was to evaluate risk factors for MR after deceased donor kidney transplantation. All patients undergoing deceased donor kidney transplantation at a single center over a three-year period were analyzed retrospective chart review for factors associated with MR. values <0.05 were considered significant. Of 141 patients, the 30-day readmission rate was 26.2 per cent. MR occurred in 43 (30.5%) patients. Age, race, gender, initial organ function, and dialysis vintage were not associated with MR. Diabetic recipients, those who received basiliximab induction, those with acute rejection, and those with unplanned reoperations were at increased risk for MR. Infection was the most common reason for initial readmission in patients with MR (23.3%). One-year patient survival and death-censored graft survival were reduced for patients with MR. MRs are required for 30 per cent of kidney transplant recipients, primarily because of infection and immunologic causes. Recipients with diabetes and those who have acute rejection are at greatest risk.
非计划再入院常被用作手术质量指标。一部分肾移植受者会经历多次再入院（MRs），尽管其发生率和危险因素尚未得到充分描述。本研究的目的是评估尸体供肾移植后MR的危险因素。对一个中心三年内接受尸体供肾移植的所有患者进行回顾性病历审查，分析与MR相关的因素。P值<0.05被认为具有统计学意义。在141例患者中，30天再入院率为26.2%。43例（30.5%）患者发生了MR。年龄、种族、性别、初始器官功能和透析时间与MR无关。糖尿病受者、接受巴利昔单抗诱导治疗的患者、发生急性排斥反应的患者以及接受非计划再次手术的患者发生MR的风险增加。感染是MR患者首次再入院最常见的原因（23.3%）。MR患者的1年患者生存率和死亡审查后的移植物生存率降低。30%的肾移植受者需要MR，主要原因是感染和免疫因素。糖尿病受者和发生急性排斥反应的患者风险最高。
