Grace, Amir A. Qamar BACKGROUND: PD0325901 price Liver transplant (LT) recipients face a significant burden of readmission in the post-transplant period. The impact of post-LT discharge status on clinical outcomes is not well-defined. The study objectives were to define post LT read-mission rates and to examine the relationship between post-LT discharge status and the risk
of readmission. METHODS:The University HealthSystem Consortium database was used to identify 12,596 patients during the index LT hospitalization (ICD9 code V42.7) between 2009 and 2013. Patients who died (N=571), were discharged to acute long term care or hospice (N=314) or were transferred to another hospital (N=182) post-operatively were excluded. Logistic regression models were used to examine the effect of discharge status EGFR inhibitor on readmission rates adjusting for baseline demographics, Charl-son comorbidities, LT length of stay (LOS), and ICU stay. RESULTS: The final study sample included 12,084 adult LT recipients. Mean age was 55±1 0 years, 72% of patients were Non-hispanic white, 10% were black, and 67% were male. The median transplant length of stay (LOS) was 1 1 days (IQR 8, 21); median number of ICU days was 3 (IQR 2, 6). A total of 54% of patients were discharged home, 30% were discharged home with home health, and 16% were discharged to a rehabilitation (1 1%) or skilled nursing facility (5%). The overall
rate of readmission was 50% (30-day readmission=1 7%, 90-day readmission=35%, and 365-day readmission=50%). The majority (73%) of readmissions were classified as emergency and 27% were elective. In multivariate analysis, after adjusting for significant covariates, post-LT discharge to a facility vs. home was independently associated with increased risk of 30-day readmission (OR 6.1, 95%CI 5.2–7.3, p<.0001), 90-day readmission (OR 4.0, 95%CI 3.6–4.5, p<.0001), and 365-day readmission (OR 3.1, 95%CI 2.7–3.6, p<.0001). Age greater than 65 was protective for
30-day readmissions (OR .81, 95%CI .68-.95, p=.01); similarly for 90-day, and 365-day readmissions. No interactions were noted between age, discharge status, and medical comorbidities. CONCLUSIONS: The burden Methamphetamine of readmission among LT recipients is significant (50% within 1 year). Post-LT discharge to a facility is an independent predictor of readmission after adjusting for medical comorbidities. While the finding of the protective effect of older age was surprising, it may reflect more conservative candidate selection among older LT recipients, and merits further investigation. The specific factors that lead to worse outcomes based on discharge status need exploration in future studies. Disclosures: Josh Levitsky – Grant/Research Support: Salix, Novartis; Speaking and Teaching: Gilead, Salix, Novartis The following people have nothing to disclose: Marina Serper, Lisa B.