ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO789

Early Readmissions Are More Common After Long Hospitalizations Among Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Walker, Adam G., DaVita Clinical Research, Minneapolis, Minnesota, United States
  • Sibbel, Scott, DaVita Clinical Research, Minneapolis, Minnesota, United States
  • Tentori, Francesca, DaVita Clinical Research, Minneapolis, Minnesota, United States
  • Brunelli, Steven M., DaVita Clinical Research, Minneapolis, Minnesota, United States
Background

Approximately one-third of dialysis patients who are hospitalized will be readmitted post discharge. In this study, we characterized patterns of readmissions by length of index hospitalizations.

Methods

Patients included in this analysis were Medicare beneficiaries, receiving in-center hemodialysis at a large dialysis organization (LDO,) and had a qualifying index hospitalization lasting ≥ 1 day during the study period (2014). Hospitalizations were considered readmissions if they occurred ≤ 30 days post-discharge from the index admission. Causes of hospitalizations were determined by primary ICD-9 diagnosis code.

Results

The mean length of stay for index admissions was 7.1 ± 9.5 days (median 4 days). The longest index hospitalizations were those due to infectious and parasitic disease and the shortest were related to endocrine, nutritional, metabolic diseases and immunity disorders. The overall probability of readmission was 31.5%; 27.6% and 52.4% of all readmissions occurred within 6 (“early readmissions”) and 12 days post-discharge, respectively. Patients with index hospitalization duration > 7 days had a higher probability of readmission overall (34.7% vs. 30.3 %) and of early readmission (30.0% vs. 26.1%) compared to those with shorter index hospitalizations.

Conclusion

These results suggest that patients with longer hospitalizations are more vulnerable to readmissions overall and to early readmissions, likely due to the severity of disease. This was particularly common among patients admitted for infections. These results raise the possibility that the clinical issue was not fully addressed during the index admission or shortly after discharge. There is a need to identify clinical practices that may help reduce readmission rates.

Funding

  • Commercial Support