The trusted source for
healthcare information and
CLEVELAND – More than half of the 17,000 patients receiving kidney transplants annually in the United States can expect to end up in the emergency department in the two years after their surgery.
In light of that, a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) calls for more effort to coordinate care for those patients.
Noting that little information is available on the incidence and risk factors associated with ED visits among kidney transplant recipients, a study team led by Cleveland Clinic researchers focused on 10,533 kidney transplant recipients from California, New York, and Florida between 2009 and 2012.
Results indicate that the cumulative incidence of ED visits at 1, 12, and 24 months was 12%, 40%, and 57%, respectively, with a median time of 19 months.
Overall, 57% of the kidney transplant recipients visited an ED within two years, and nearly half of those ED visits, 48%, led to hospital admission.
Risk factors for those visits include younger age, females, black and Hispanic race/ethnicity, public insurance, depression, diabetes, peripheral vascular disease, and frequent use of EDs prior to transplantation.
"These data provide fundamental baseline information concerning the scope and factors of emergency department visits and potential interventions and target populations for future study," said lead researcher Jesse Schold, PhD. "It is crucially important that emergency department clinicians are cognizant of the specific issues pertinent to transplant recipients given unique medical issues. Moving forward, tailored interventions, particularly to patients and institutions with high rates of emergency department visits following discharge, may be important."
In an accompanying editorial, Lorien Dalrymple, MD, MPH, and Patrick Romano, MD, MPH, of the University of California at Davis, called the study "important as it extends prior findings that were limited to single centers and addresses an understudied topic."