Affiliation:
1. Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine University of California Los Angeles California USA
2. Department of Surgery University of Colorado Denver Colorado USA
3. Department of Surgery, David Geffen School of Medicine University of California, Los Angeles Los Angeles California USA
Abstract
AbstractIntroductionAlthough not formalized into current risk assessment models, frailty has been associated with negative postoperative outcomes in many specialties. However, national analyses of the association between frailty and post‐transplant outcomes following kidney transplantation (KT) are lacking.MethodsThis was a retrospective cohort study of adults undergoing KT from 2016 to 2020 in the Nationwide Readmissions Databases. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups frailty indicator.ResultsOf an estimated 95 765 patients undergoing KT during the study period, 4918 (5.1%) were frail. After risk adjustment, frail patients were associated with significantly higher odds of in‐hospital mortality (AOR 2.17, 95% CI: 1.33–3.57) compared to their non‐frail counterparts. Our findings indicate that frail patients had an average increase in postoperative hospital stay of 1.44 days, a $2300 increase in hospitalization costs, as well as higher odds of developing a major perioperative complication as compared to their non‐frail counterparts. Frailty was also associated with greater adjusted risk of non‐home discharge.ConclusionsFrailty, as identified by administrative coding, is independently associated with worse surgical outcomes, including increased mortality and resource use, in adults undergoing KT. Given the already limited donor organ pool, novel efforts are needed to ensure adequate optimization and timely post‐transplantation care of the growing frail cohort undergoing KT.