Evidence map›Paper›PMID 27941434›Full record

ArticleTransplantation2017

Mortality and Graft Loss Attributable to Readmission After Kidney Transplantation: Immediate and Long-term Risk.

Elizabeth A King, Mary Grace Bowring, Allan B Massie, Lauren M Kucirka, Mara A McAdams-DeMarco, Fawaz Al-Ammary, Niraj M Desai, Dorry L Segev

Abstract readMulticenter Study
In one paragraph

Article in Transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Association of DGF and Early Readmissions on Outcomes Following Kidney Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2022
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Hospital readmissions following HLA-incompatible live donor kidney transplantation: A multi-center study.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2018
    Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Elizabeth A King1 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 2 Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD. 3 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Mary Grace Bowring
Allan B Massie
Lauren M Kucirka
Mara A McAdams-DeMarco
Fawaz Al-Ammary
Niraj M Desai
Dorry L Segev

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Technological Assessment and Solutions Core - RC4P30AG021334 · NIA · JOHNS HOPKINS UNIVERSITY · PI Jeremy D Walston · 2003 to 2026
$33.2M
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Frailty and Adverse Health Outcomes of Aging in Older Adults with Kidney FailureK01AG043501 · NIA · JOHNS HOPKINS UNIVERSITY · PI MCADAMS DEMARCO, MARA A. · 2014 to 2018
$624k
Geriatric-Specific Risks and Outcomes in Older Kidney Tranplant RecipientsF32AG044994 · NIA · JOHNS HOPKINS UNIVERSITY · PI KING, ELIZABETH ANN · 2013 to 2015
$210k
NIA NIH HHS F32 AG044994NIA NIH HHS K01 AG043501NIA NIH HHS P30 AG021334NIDDK NIH HHS K24 DK101828NIGMS NIH HHS T32 GM007309
6 · The paper itself

Abstract

backgroundAfter kidney transplantation, early readmission is independently associated with graft loss and mortality. The mechanism of this association is poorly understood. Understanding the timeline of risk, that is, during the readmission hospitalization versus periods postreadmission, will provide additional insights.

methodsWe used national registry data to study 56 076 adult Medicare-primary first-time kidney transplant recipients from December 1999 to October 2011. Piecewise Cox proportional hazard models were used to estimate the association between graft loss, mortality, and readmission for 2 periods: readmission hospitalization and postreadmission.

resultsDuring the readmission hospitalization, graft loss was substantially higher (deceased donor kidney transplant [DDKT] without delayed graft function [DGF] hazard ratio: 24.634.447.9, P < 0.001; with DGF: 10.815.221.4, P < 0.001; live donor kidney transplant [LDKT]: 18.136.774.2, P < 0.001) and mortality was substantially higher (DDKT without DGF: 14.120.830.7, P < 0.001; with DGF: 9.0312.818.0, P < 0.001; LDKT: 9.0018.241.3, P < 0.001). Immediately after readmission discharge, graft loss (DDKT without DGF: 2.082.402.77, P < 0.001; with DGF: 1.832.142.51, P < 0.001; LDKT: 2.002.503.13, P < 0.001), and mortality (DDKT without DGF: 2.162.432.73, P < 0.001; with DGF: 1.832.162.88, P < 0.001; LDKT: 1.902.342.88, P < 0.001) remained elevated, but much less so. After readmission, the hazard of graft loss remained, but decreased 19% per year for DDKT recipients (time varying coefficient 0.780.810.85, P < 0.001) and 14% per year for LDKT recipients (0.790.860.93, P < 0.001). The hazard of mortality remained, but decreased 14% per year for DDKT recipients (0.830.860.89, P < 0.001) and 9% per year for LDKT recipients (0.850.910.98, P < 0.001).

conclusionsIn conclusion, readmission is most strongly associated with graft loss and mortality during the readmission hospitalization, but also portends a lasting, albeit attenuated, risk postreadmission.

Indexed as

ForecastingGraft SurvivalTransplant RecipientsAdultDelayed Graft FunctionFemaleFollow-Up StudiesHumansIncidenceKidney TransplantationLiving DonorsMaleMiddle AgedPatient ReadmissionRegistriesRetrospective Studies

Identifiers

PMID27941434
PMCPMC5462864

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.