Readmissions to a Nephrology Service in Abidjan: Prevalence and Risk Factors

Abstract

Background: Readmission of patients with kidney disease is a reality in our practice setting. Objectives: To assess the prevalence of readmission and identify factors associated with readmission and death of readmitted patients. Materials and Methods: This was a retrospective study conducted from the 1st of October 2017 to the 31st of December 2019 in the nephrology department of Treichville Teaching Hospital. Results: During the study period, 1142 patients were admitted, of whom 154 patients were readmitted, representing a prevalence of 13.48%. The mean age of the patients was 42.31 [15; 77 years] and the sex ratio was 1.35 in favour of men. The unemployed were the most represented (24.78%). The average time between hospitalisations was 28.23 ± 21.83 days [3; 123 days]. Patients were readmitted within 30 days of discharge in 65.48% of cases, between 30 and 60 days in 23.90% and after 60 days in 10.62%. The uremic syndrome was the main reason for readmission (68, 14%). The causes of readmission were dominated by dialysis failure (82.30%), followed by complications of vascular access, notably dialysis catheter infection (10.60%). Mortality was 30.97%. Obstructive nephropathy (p = 0.029) and hypocalcaemia (p = 0.030) were associated with the risk of hospital mortality. Severe anaemia was associated with early readmission (p = 0.047) and hypertension with the risk of non-early readmission. Conclusion: The prevalence of readmission at hospitals is high. The causes are dominated by dialysis failure and dialysis catheter infection. Hence, there is an interest in improving accessibility to dialysis for patients and raising awareness on prevention and management of risk factors of chronic kidney disease.