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- Title
Pre-kidney transplant lower extremity impairment and transplant length of stay: a time-to-discharge analysis of a prospective cohort study.
- Authors
Nastasi, Anthony J.; Bryant, Tyler S.; Le, Jimmy T.; Schrack, Jennifer; Hao Ying; Haugen, Christine E.; Fernández, Marlís González; Segev, Dorry L.; McAdams-DeMarco, Mara A.; Ying, Hao; González Fernández, Marlís
- Abstract
<bold>Background: </bold>Few objective tests can be performed at admission for kidney transplantation [KT] to discern risk of increased length of stay [LOS], which is important for patient counseling and is associated with increased costs and mortality. The short physical performance battery [SPPB] is an easily administered, potentially modifiable, 3-part test of lower extremity function. SPPB score is associated with longer hospital LOS in older adults, and may provide similar utility in KT recipients given that ESRD is a disease of accelerated aging. The aim of this study was to characterize the association between SPPB-derived lower extremity function and LOS.<bold>Methods: </bold>The SPPB was administered at KT admission in a prospective cohort of 595 recipients (8/2009-6/2016). The independent association between SPPB impairment (score ≤ 10) and LOS was tested with an adjusted conventional generalized gamma parametric survival model.<bold>Results: </bold>Impaired recipients experienced longer LOS (median: 10 vs. 8 days; P < 0.001) with the greatest difference in percent discharged on day 10 (impaired: 54.5%, unimpaired: 73.3%). Discharge typically took 13% longer in the impaired group (relative time = 1.13; 95%CI: 1.05, 1.21, P = 0.001). Discharge for impaired recipients compared to unimpaired was least likely at day 5 (hazard ratio = 0.71; 95% CI:0.68, 0.74, P < 0.001). No differences in the SPPB impairment-LOS relationship were found by age (interaction P = 0.74).<bold>Conclusions: </bold>Pre-KT SPPB impairment was independently associated with longer LOS regardless of age, indicating that it is a useful, objective tool for pre-KT risk assessment in younger and older recipients that may help inform discharge planning.
- Subjects
KIDNEY transplantation; HOSPITAL admission &; discharge; LENGTH of stay in hospitals; PATIENT education; HEALTH risk assessment
- Publication
BMC Geriatrics, 2018, Vol 18, p1
- ISSN
1471-2318
- Publication type
journal article
- DOI
10.1186/s12877-018-0940-y