title: Early Hospital Readmissions After Transplantation: Burden, Causes, and Consequences.
abstract: BACKGROUND
  Solid organ transplantation is the preferred treatment for patients with end-stage organ failure. Although much progress has been made over the past decade, some patients still require early readmission after their initial hospital discharge. Early hospital readmission is an important metric for health care quality. It is often measured in nontransplant medical and surgical conditions but has only recently been applied to organ transplantation.
  
  
  METHODS
  We performed a structured MEDLINE search to retrieve, review, and summarize original studies on the incidence, risk factors, outcomes, and prevention of early hospital readmissions after kidney, liver, and kidney-pancreas transplantation. Early hospital readmission was defined as readmission to hospital within 30 days of discharge from the transplant hospitalization.
  
  
  RESULTS
  The risk of early readmission varies by organ type, (highest in liver transplants and lowest in kidney transplants). Causes for early hospital readmission are most commonly due to surgical, immunologic, or infectious complications. Risk factors associated with early hospital readmission often reflect pretransplant comorbidity, and many of these factors may not be modifiable. Early hospital readmission is also associated with decreased graft and patient survival.
  
  
  CONCLUSIONS
  Early hospital readmission after transplantation is common and associated with adverse outcomes. The potential for preventing early hospital readmissions and the impact on patient outcomes remain unclear. Current evidence suggests that some, but not all, early hospital readmissions after transplantation may be prevented.
authors.affiliation: 1 Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada. 2 Division of Nephrology, Western University, London, Ontario, Canada. 3 Institute for Clinical Evaluative Sciences, Ontario, Canada. 4 Division of Nephrology and Ottawa Hospital Research Institute, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada. 5 Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alvin Ho-ting
authors.initials: AH
authors.lastname: Li
authors.forename: Ngan N
authors.initials: NN
authors.lastname: Lam
authors.forename: Kyla L
authors.initials: KL
authors.lastname: Naylor
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.forename: Greg A
authors.initials: GA
authors.lastname: Knoll
authors.forename: S Joseph
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D016035:Pancreas Transplantation / Q000009:adverse effects* / Q000401:mortality; D010359:Patient Readmission; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome