2016, Number 3
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Ann Hepatol 2016; 15 (3)
Predictors and impacts of hospital readmissions following liver transplantation
Yataco, M , Cowell, A , Waseem, D , Keaveny, AP , Taner, CB , Patel, T
Language: English
References: 16
Page: 356-362
PDF size: 148.28 Kb.
ABSTRACT
While liver transplantation is the definitive therapy for end stage liver disease, it remains a major procedure, with many potential complications.
Hospital readmissions after the initial hospitalization for liver transplantation can be associated with adverse outcomes, increased
cost, and resource utilization. Our aim was to define the incidence and reasons for hospital readmission after liver transplant
and the impact of readmissions on patient outcomes. We retrospectively analyzed 30- and 90-day readmission rates and indications
in patients who underwent liver transplant at a large-volume transplant center over a 3-year period. Four hundred seventy-nine adult
patients underwent their first liver transplant during the study period. The 30-day readmission rate was 29.6%. Recipient and donor
age, etiology of liver disease, biological Model for End-Stage Liver Disease score, and cold ischemia time were similar between patients
who were readmitted within 30 days and those who were not readmitted. Readmissions occurred in 25% of patients who were
hospitalized prior to liver transplant compared to 30% who were admitted for liver transplant. The most common indications for
readmission were infection, severe abdominal pain, and biliary complications. Early discharge from hospital (fewer than 7 days after
liver transplant), was not associated with readmission; however, a prolonged hospital stay after liver transplant was associated with
an increased risk of readmission (p = 0.04). In conclusion, patients who undergo liver transplant have a high rate of readmission. In
our cohort, readmissions were unrelated to pre-existing recipient or donor factors, but were associated with a longer hospital stay after
liver transplant.
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