Risk factors for 30-day readmission following liver transplantation in Pennsylvania

Abstract

BackgroundReadmissions after liver transplantation (LT) are common given the complexity of the procedure, the severity of illness of patients, and complications related to immunosuppression. The objectives of this research were to identify risk factors for 30-day readmission and length of stay (LOS) for patients undergoing LT in Pennsylvania (PA). MethodsData from the Pennsylvania Health Care Cost Containment Council (PHC4) were used to identify 1,163 patients admitted to 10 liver transplant centers in Pennsylvania for liver transplantation between 2010 and 2018. Logistic and generalized linear regression models were used to estimate risk factors for 30-day readmission and LOS, respectively, adjusting for patient, disease, and hospital characteristics. ResultsOf the 1,163 patients receiving LT, 361 (31.1%) required readmission within 30 days, most frequently for surgical complication (23.5%). Both 30-day readmission rates and LOS showed a decreasing trend from 2010 to 2018. Readmitted patients were more likely to be younger than 60, female, have had a longer LOS, have been discharged to a skilled nursing facility, and have concomitant comorbid renal disease. Longer LOS was associated with patients who had an emergent admission, were transferred from another acute care institution, had surgical complications, and were discharged to a skilled nursing facility. We also found that age, hospital volume, and comorbidities were associated with longer LOS. ConclusionsPatient demographics, including age, sex, and race/ethnicity are associated with readmission and LOS following LT in PA. These results may be useful in guiding efforts to prevent readmissions.