Early rehospitalization after initial chronic kidney disease educational hospitalization relates with a multidisciplinary medical team

Abstract

BackgroundIt is well-documented that chronic kidney disease (CKD) often results in end-stage renal failure and puts patients at extremely high risk for developing cardiovascular disease. Educational hospitalization at medical institutions in Japan is important for patients with CKD because it facilitates treatment in earlier stages of CKD when subjective symptoms are not apparent. However, some patients who have achieved their educational targets tend to have poor compliance at home after discharge from the hospital, resulting in rehospitalization shortly. In this study, we examined the factors for early rehospitalization of patients after initial CKD educational hospitalization compared with non-rehospitalized patients.MethodsOne hundred thirty-seven patients after discharge from CKD educational hospitalization in Japan between March 2011 and December 2012 were included in the analyses. The subjects were classified into two groups: the early rehospitalization group and control group. We adjusted for confounding variables and performed multiple logistic regression analysis with the presence or absence of early rehospitalization as a dependent variable to investigate the association of early rehospitalization with patient background features, laboratory data, vital signs, instruction-related items, and home environment.ResultsStudy subjects included 22 patients in the early hospitalization group and 115 patients in control group. Multivariable analysis for early rehospitalization indicated that insufficient instruction by physician, pharmacist, and dietitians was independent explanatory variable. Analyzing by Kaplan–Meier method, the probability of non-rehospitalization in the instruction group was significantly higher than that in the non-instruction group. Therefore, we believe it is necessary to involve a competent, multidisciplinary medical team (consisting of physicians, pharmacists, and dietitians) in addressing the early rehospitalization issue in patients with CKD.ConclusionThese findings confirm the importance of care by a multidisciplinary medical team in patients with CKD. Therefore, we suggest that care by a multidisciplinary medical team reduces the increase of early rehospitalization in patients with CKD.

The Relevance of High Pulse Pressure and Renal Function in Patients with Chronic Kidney Disease: Analysis for each Stage of Chronic Kidney Disease

“…Patients will be able to self-control by acquiring the knowledge necessary for the prevention of severity and improving lifestyle through educational hospitalization for CKD. Early rehospitalization rate was suppressed by 36.2% because of the instruction of multidisciplinary medical teams including physicians, pharmacists, nurses, and dietitians compared to the individual medical specialists at CKD educational hospitalization in our previous study [16]. Taken together, treatment by a multidisciplinary medical team is important for CKD educational hospitalization in predialysis patients with CKD.…”

Factors associated with readmission in chronic kidney disease: Systematic review and meta‐analysis

“…Within the CKD group, 13 (93%) studies examined factors associated with readmission at one single timepoint; at 30 days (Ferrandino et al, 2017; Garlo et al, 2015; Jasinski et al, 2017; Kose et al, 2016; Montgomery et al, 2019; Perkins et al, 2013; Saheb sharif‐Askari et al, 2014; Xie et al, 2015), 3 months (Bohlouli et al, 2017; Edmonston et al, 2019), 6 months (Smilowitz et al, 2020), 2 years and a readmission period of 12–45 months (Mcpherson et al, 2014). Only one study by Tesfaye et al (2019) included two timepoints; 30 days and 3 months.…”