P0968 - Gender Disparities in Index and Early (30-Day) Liver Transplant Readmissions: Where Do We Stand?

Aakriti Soni, MD¹, Anuroop Yekula, MD¹, Dushyant Singh. Dahiya, MD², Yuvaraj Singh, MD³, Hassam Ali, MD⁴, Saurabh Chandan, MD⁵, Manesh Kumar Gangwani, MD⁶, Muhammad Aziz, MD⁶, Jay Bapaye, MBBS, MD⁷, Babu Mohan, MD, MS⁸, Sumant Inamdar, MD⁹, Madhusudhan R.. Sanaka, MD¹⁰, Nimish Thakral, MD¹¹, George M. Abraham, MD, MPH^1
1Saint Vincent Hospital, Worcester, MA; ²University of Kansas School of Medicine, Kansas City, KS; ³University of Massachusetts, Worcester, MA; ⁴ECU Health Medical Center / Brody School of Medicine, Greenville, NC; ⁵Creighton University School of Medicine, Omaha, NE; ⁶University of Toledo, Toledo, OH; ⁷Rochester General Hospital, Rochester, NY; ⁸University of Utah Health School of Medicine, Salt Lake City, UT; ⁹University of Arkansas, Toledo, OH; ¹⁰Cleveland Clinic Foundation, Cleveland, OH; ¹¹University of Kentucky, Lexington, KY

Introduction: Liver transplant (LT) is associated with increased risk of hospital readmission, thus placing a significant burden on the United States (US) healthcare system. Gender gaps in LT have been well documented however, there is limited data on gender disparities for early (30-d) readmissions of LT.

Methods: The National Readmission Database (NRD) was analyzed to identify all adult (≥18 years old) index and 30-day readmissions of LT in the US from October 2015-November 2019. The population was further divided into 2 groups based on gender. Hospitalization characteristics and clinical outcomes were compared between index and 30-d readmission of LT. All p-values ≤0.05 were considered statistically significant.

Results: There were 2,263 male and 1,281 female index LT hospitalizations in the US. Of these,1,202 (53.1%) males and 671 (52.4%) females were readmitted within 30-d. We did not find a statistical difference in the mean age for index and 30-d readmissions of LT for males (58 vs 58 years, p=0.69) or females (57 vs 56, p=0.39); the 50–64 age group had the highest number of index and 30-d readmissions for both genders. As expected, both index and 30-d readmissions were higher in males and females with higher co-morbidities, without a statistically significant difference (Table 1). High volume LT centers had a higher proportion of 30-d readmissions compared to index hospitalizations for males (64.1% vs 45.8%, p< 0.001) and females (64.4% vs 44,3%, p< 0.001). We did not find a statistical difference in the all-cause mortality for index and 30-d readmissions of LT for males (2.5% vs 2.7%, p=0.46) or females (3% vs 3.3%, p=0.86) [Table 1]. The 30-d readmission of LT had a shorter median length (LOS) of stay for males (11 vs 13 days, p< 0.001) and females (13 vs 15 days, p=0.023) compared to the index admission. The median total hospital charge (THC) was also lower for 30-d readmission of LT for males ($373,302 vs $486,900, p< 0.001) and females ($402,110 vs $502,338, p< 0.001) compared to the index admission.




Discussion: Although fewer index LT hospitalization were women, 30-d readmission rate was comparable to that for men. Large volume centers were noted to have the highest 30-d readmissions of LT for both genders, reflecting a higher degree of complexity of these patients. Overall, index and 30-d readmissions of LT for females had higher all-cause mortality, longer LOS, and higher THC compared to males. Large, prospective, multi-center studies are needed to further validate these findings.



Disclosures:


Aakriti Soni, MD¹, Anuroop Yekula, MD¹, Dushyant Singh. Dahiya, MD², Yuvaraj Singh, MD³, Hassam Ali, MD⁴, Saurabh Chandan, MD⁵, Manesh Kumar Gangwani, MD⁶, Muhammad Aziz, MD⁶, Jay Bapaye, MBBS, MD⁷, Babu Mohan, MD, MS⁸, Sumant Inamdar, MD⁹, Madhusudhan R.. Sanaka, MD¹⁰, Nimish Thakral, MD¹¹, George M. Abraham, MD, MPH¹. P0968 - Gender Disparities in Index and Early (30-Day) Liver Transplant Readmissions: Where Do We Stand?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.