Year 2022 / Volume 114 / Number 5
Original
Emergency department frequentation and unscheduled readmissions within the first year after liver transplantation, and their impact on survival

266-271

DOI: 10.17235/reed.2021.7666/2020

Paula Molina Ávila, María Jesús Citores Sánchez, Ana Arias Milla, Laura Benítez, Esther Montero Herández, Valentín Cuervas Mons,

Abstract
The aim of this study was to assess emergency room frequentation, visit causes, and unscheduled readmissions within the first year after discharge from hospital following liver transplantation. Their impact on graft and patient survival was also assessed. This was a retrospective study of the medical records of 98 patients (mean age, 55.6 ± 8.59 years, 77.6 % males) who were consecutively discharged from hospital after undergoing a first liver transplant in our institution during 2012-2015. All visits to the emergency room during the first years after transplantation were analyzed, and survival at two years after transplantation was calculated. Fifty-six of the 98 patients (57.15 %) visited the emergency room on 117 occasions within the first year post-transplantation. Fever (n = 34; 29.05 %) and digestive symptoms (n = 32; 27.35 %) were the most common causes of consultation, and resulted in over half of visits. Thirty-five of these 56 patients (62.5 %) required an urgent readmission during 50 of the 117 (42.7 %) visits. This was primarily due to infectious complications (44 %) of diverse causes (bacterial pneumonia, cholangitis, Clostridium difficile colitis) and biliary tract-related issues. The likelihood of readmission increased from 11.22 % at 30 days after discharge to 22.4 % at 90 days after discharge. Patient survival at 1 and 2 years after transplantation was lower for patients who were readmitted (88.4 % and 80.7 %, respectively) when compared to those who were not readmitted (95.56 % and 91.17 %, respectively, p = 0.002).
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References
1. Unidad de urgencias hospitalaria. Estándares y recomendaciones. Informes, estudios e investigación 2010. Ministerio de Sanidad y Política Social.
2. Oh SY, Lee JM, Lee H, et al. Emergency department visits and unanticipated readmissions after liver transplantation: A retrospective observational study. Sci Rep 2018;8:4084-92.
3. McElroy LM, Schmidt KA, Richards CT, et al. Early Postoperative Emergency Department Care of Abdominal Transplant Recipients. Transplantation 2015;99:1652-7.
4. Unterman S, Zimmerman M, Tyo C, et al. A descriptive analysis of 1251 solid organ transplant visits to the emergency department. E West J Emerg Med 2009;10:48-54.
5. Savitsky EA, Votey SR, Mebust DP, et al. A descriptive analysis of 290 liver transplant visits to an emergency department. Acad Emerg Med 2000;7:898-905.
6. Wilson GC, Hoehn RS, Ertel AE, et al. Variation by center and economic burden of readmissions after liver transplantation. Liver Transpl 2015;21:953-60.
7. Russo MW, Levi DM, Pierce R, et al. A prospective study of a protocol that reduces readmission after liver transplantation. Liver Transpl 2016;22:765-72.
8. Paterno F, Wilson GC, Wima K, et al. Hospital utilization and consequences of readmissions after liver transplantation. Surgery 2014;156:871-8.
9. Brennan JJ, Chan TC, Killeen JP, et al. Inpatient Readmissions and Emergency Department Visits within 30 Days of a Hospital Admission. West J Emerg Med 2015;16:1025-9.
10. Tsai TC, Joynt KE, Orav EJ, et al. Variation in Surgical-Readmission Rates and Quality of Hospital Care. N Engl J Med 2013;369:1134-42.
11. Pereira AA, Bhattacharya R, Carithers R, et al. Clinical factors predicting readmission after orthotopic liver transplantation. Liver Transpl 2012;18:1037-45.
12. Yataco M, Cowell A, David W, et al. Predictors and impacts of hospital readmissions following liver transplantation. Ann Hepatol 2016;15:356-62.
13. Li AH, Lam NN, Naylor KL, et al. Early Hospital Readmissions After Transplantation: Burden, Causes, and Consequences. Transplantation 2016;100:713-8.
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Molina Ávila P, Citores Sánchez M, Arias Milla A, Benítez L, Montero Herández E, Cuervas Mons V, et all. Emergency department frequentation and unscheduled readmissions within the first year after liver transplantation, and their impact on survival . 7666/2020


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Publication history

Received: 20/11/2020

Accepted: 28/12/2020

Online First: 25/01/2021

Published: 06/05/2022

Article revision time: 29 days

Article Online First time: 66 days

Article editing time: 532 days


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