title: Early readmission is a predictor of overall survival following isolated lung transplantation.
abstract: Causes of early readmissions following lung transplantation are not well understood, and the impact is poorly reported. We reviewed 221 consecutive lung transplantations and identified patients readmitted within 90 days. A case control analysis was performed to determine the characteristics that predict readmission and the impact of readmission on survival. Ninety (44%) of the 205 operative survivors required a total of 125 readmissions during the 90 days after transplantation. Twenty-eight patients (13.7%) required multiple readmissions. Causes for readmissions were pulmonary complication (59%), gastrointestinal (18%), cardiac (5%), metabolic (2.5%), neurological (2.5%), hematological (2%), and miscellaneous (11%). The sex, native disease, or type of transplant did not predict readmission. Requirement of cardiopulmonary bypass for transplantation showed a trend toward significance (P = 0.08). The 90-day conditional survival at 1, 3, and 5 years for those patients readmitted within 90 days were 76%, 59%, and 52%, respectively, compared to 93%, 80%, and 76% for patients not readmitted (P = 0.01). Requirement for readmission within 90 days following transplantation is associated with increased mortality. Sex, native disease, and type of transplant are not predictors of readmission or survival.
authors.affiliation: Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 5040, Chicago, IL 60637, USA. wvignesw@surgery.bsd.uchicago.edu
authors.forename: Wickii T
authors.initials: WT
authors.lastname: Vigneswaran
authors.forename: Marta
authors.initials: M
authors.lastname: Helenowski
authors.forename: Sangeeta M
authors.initials: SM
authors.lastname: Bhorade
authors.forename: Fernando
authors.initials: F
authors.lastname: Lamounier
authors.forename: Charles
authors.initials: C
authors.lastname: Alex
authors.forename: Edward R
authors.initials: ER
authors.lastname: Garrity
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D015996:Survival Rate