E. Lushaj1, T. Kohmoto1, L. Lozonschi1, S. Osaki1, A. Badami1, S. Ulschmidt1, S. Akhter1 1University Of Wisconsin,Cardiothoracic/Surgery,Madison, WI, USA
Introduction: Complications often occur long after heart transplantation (HT), requiring hospital readmission. Our goal was to identify the rate and etiology of unplanned readmissions following HT. We also analyzed the impact of unplanned readmissions on post-transplant survival.
Methods: We retrospectively reviewed 133 patients undergoing HT at our institution from 01/2004 to 05/2014. Six patients who expired during the index hospitalization were excluded from the analysis.
Results:Of the sample (n=127) 98 (77%) patients were readmitted 324 times (3.3 times/patient) as of end of follow-up. The median follow-up period was 56 (IQR: 21-105) months. Median time to first readmission was 59 (IQR: 10-185) days. Over half of readmissions (n=186; 57%) were within the first year post-discharge at index hospitalization. Of those, 52 (28%) were within 30 days post-discharge. Freedom from first readmission was observed for 66% of patients at 1 month, 51% at 3 months, 29% at 6 months and 18% at 12 months (Figure). Median hospital length of stay at readmission was 3 (IQR: 2, 6) days. Age, gender, BMI, previous LVAD support, surgery or CPB time at transplant, hospital and ICU length of stay were not risk factors for readmission. Readmission etiology included infections (23%), GI complications (15%), respiratory (14%), rejection (11%), cardiac (10%), renal (7%), cardiac allograft vasculopathy (2%). Readmissions due to infections included respiratory (32%), GI (22%), wound (16%), cytomegalovirus (5%). There was no significant difference in the long-term survival between readmitted and non-readmitted patients (Log-rank test: p=0.68).
Conclusion:The first year after discharge remains a high risk period for transplanted patients. Infections and GI complications were the leading causes of readmission. Readmissions did not negatively impact long-term survival of transplanted patients.
