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Kidney Week

Abstract: FR-PO219

Post-Discharge Readmission Outcomes Following Hyperkalemia-Related Hospitalization

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Woolley, J. Michael, AstraZeneca, Wilmington, Delaware, United States
  • Betts, Keith, Analysis Group, Inc. , Los Angeles, California, United States
  • Mu, Fan, Analysis Group, New York, New York, United States
  • Wang, Yao, Analysis Group, New York, New York, United States
  • Kelkar, Sneha S., Analysis Group, Inc. , Los Angeles, California, United States
  • Wu, Eric, Analysis Group, New York, New York, United States
Background

The objective of this study was to compare post-discharge outcomes, including hospital readmission rates, lengths of stay (LOS) per readmission, and total inpatient days, between hospitalizations in patients with and without hyperkalemia (HK).

Methods

Adults with available potassium lab results and at least one hospitalization were identified from a large US claims database (1/1/2010-12/31/2014). Hospitalizations with an HK diagnosis (ICD-9 276.7) were defined as case hospitalizations (cases), and hospitalizations from patients without HK (no HK diagnosis, no potassium lab tests above 5.0 mEq/L, and no sodium polystyrene sulfonate use) were defined as control hospitalizations (controls). Cases and controls were required to have continuous enrollment from 6 months prior to admission to 12 months after discharge from the hospitalization. Controls were matched 1:1 to cases on age, chronic kidney disease (CKD) stage, dialysis treatment, heart failure (HF), renin-angiotensin-aldosterone system inhibitor (RAASi) use, major diagnostic categories, and selected diagnosis-related groups. Readmission rates, LOS per readmission, and total inpatient days during the 1-year post-discharge period were assessed using Wilcoxon signed-rank and McNemar tests. Analysis was repeated in patients with CKD and/or HF.

Results

A total of 5,377 hospitalizations with HK (cases) were matched to hospitalizations without HK (controls). Compared with controls, cases had higher rates of readmission (30-day: 12.5% vs. 8.4%; 60-day: 18.3% vs. 12.7%; 90-day: 24.3% vs. 16.8%). Cases also had longer LOS per readmission (8.1 vs. 7.1 days) and more total inpatient days (10.5 vs. 5.8 days) during the 1-year post-discharge period (all p<0.001). In patients with CKD and/or HF, cases had higher rates of readmission (30-day: 13.8% vs. 9.4%, 60-day: 19.8% vs. 14.3%, 90-day: 26.5% vs. 19.2%), longer LOS per readmission (8.4 vs. 7.4 days), and more total inpatient days (12.4 vs. 7.2 days) during the 1-year post-discharge period compared with controls (all p<0.001).

Conclusion

Post-discharge, hyperkalemia-related hospitalizations were associated with higher readmission rates, longer lengths of stay per readmission, and higher total inpatient days.

Funding

  • Commercial Support