Early and recurrent hospitalization after kidney transplantation: Analysis of a contemporary canadian cohort of kidney transplant recipients

Hospital readmission is a common occurrence following kidney transplantation, but less is known about the predictors of early and recurrent hospitalization. We analyzed a cohort of adult kidney transplant recipients in Nova Scotia, Canada, from January 2010 to December 2015. Readmission rates for 30 days, 6 months, and 1 year were calculated as a proportion of total transplants. Factors independently associated with early readmission were investigated using multivariable Cox hazards models with multivariable Anderson-Gill Cox models being used for factors independently associated with recurrent readmission. Of the 213 patients included, 41 (19.2%), 78 (36.6%), and 88 (41.3%) were readmitted to hospital within 30 days, 6 months, and 1 year, respectively. On multivariable analyses, a history of congestive heart failure (HR 1.741, 95% CI 1.039-2.918), peptic ulcer disease (HR 2.290, 95% CI 1.054-4.973), and liver disease (HR 2.492, 95% CI 1.162-5.344) was associated with higher risk of first rehospitalization. Recurrent hospital admission was associated with initial hospital duration ≥ 8 days (HR 2.140, 95% CI 1.265-3.618), congestive heart failure (HR 1.366, 95% CI 1.044-1.787), and liver disease (HR 1.785, 95% CI 1.257-2.534). Increasing duration of initial hospitalization, congestive heart failure, and liver disease are important to consider when evaluating a patient's risk for recurrent readmission following kidney transplant.