Department of Pharmacy Practice, 15508University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.
Department of Surgery, 14681University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Prog Transplant. 2021 Mar;31(1):72-79. doi: 10.1177/1526924820978596. Epub 2020 Dec 23.
Early emergency department and hospital re-admissions are common in renal transplant recipients, but data are lacking in unique populations. Study Aim: The purpose of this study was to identify patient risk factors for multiple acute care utilization events within the first year of renal transplantation.
This was a single-center, retrospective cohort study of adult renal transplant recipients between 9/2013-9/2016. Patients were compared across number of emergency department visits and by hospital re-admissions. Diagnoses were categorized. Univariate and multivariate logistic regression was used to assess risk for multiple acute care utilization events within the first 12 months post-transplant.
A total of 216 patients were analyzed and were on average 50.5 (SD 13.9) years old, redominantly Black (49.77%) with an average body mass index of 33.33 (9.8) and were recipients of deceased donor renal transplants (61.11%). A total of 105 (48.6%) patients visited the emergency epartment and 119 (55.1%) patients had a hospital readmission. Patients having a body mass index >35 kg/m2 did not differ across emergency department visit or hospitalization groups. Delayed graft function (OR 2.86, 95% CI 1.07-7.65) and previous renal transplant (OR 2.77, 95% CI 1.04-7.39) were significantly associated with multiple acute care utilizations.
Acute care utilization following renal transplantation was similar to previously reported experiences. Obesity did not impact use of acute care resources or patient outcomes. Strategies addressing potential preventable emergency visits and hospital re-dmissions should be promoted.
肾移植受者在早期急诊和住院后再次入院很常见,但在特殊人群中缺乏数据。研究目的:本研究的目的是确定肾移植后 1 年内多次急性护理利用事件的患者危险因素。
这是一项对 2013 年 9 月至 2016 年 9 月期间在单一中心接受肾移植的成年肾移植受者的回顾性队列研究。比较了急诊就诊次数和住院再入院的患者。对诊断进行了分类。使用单变量和多变量逻辑回归来评估移植后 12 个月内多次急性护理利用事件的风险。
共分析了 216 例患者,平均年龄为 50.5(标准差 13.9)岁,以黑人为主(49.77%),平均体重指数为 33.33(9.8),且均为已故供体肾移植受者(61.11%)。共有 105 例(48.6%)患者就诊于急诊部,119 例(55.1%)患者住院。体重指数(BMI)>35kg/m2 的患者在急诊就诊或住院分组中无差异。延迟移植物功能(OR 2.86,95%CI 1.07-7.65)和既往肾移植(OR 2.77,95%CI 1.04-7.39)与多次急性护理利用显著相关。
肾移植后急性护理利用与先前报道的经验相似。肥胖并未影响急性护理资源的利用或患者结局。应推广针对潜在可预防急诊就诊和住院再入院的策略。