Early Post-Transplant Readmission Linked to Frailty

SEATTLE—Frailty independently predicts early hospital readmission after kidney transplantation, according to data presented at the 2013 American Transplant Congress.

In a study of 383 kidney transplant recipients, Mara McAdams-DeMarco, PhD, and colleagues at Johns Hopkins University School of Medicine in Baltimore found that frailty was associated with a significant 60% increased likelihood of early hospital readmission, defined as readmission within 30 days of the initial transplant-related discharge. This increased risk was the same for frail patients aged 65 and older and those younger than 65.

In addition, frail recipients younger than age 65 had a significantly higher early readmission rate than non-frail recipients aged 65 and older.

Frailty is characterized by decreased walking speed, decreased grip strength, exhaustion, low physical activity, and unexplained weight loss. At the time of transplantation, 18.4% of patients were frail. Of these, 45.8% experienced early hospital readmission compared with only 28.0% of those who were not frail, Dr. McAdams-DeMarco reported. The association between frailty and early hospital readmission was independent of transplant and other recipient factors.

In a presentation before colleagues, Dr. McAdams-DeMarco concluded that frail kidney transplant recipients could be a target for better transition of care at discharge, which may potentially reduce early hospital readmission rates.

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