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Understanding beyond words: The impact of English proficiency in postoperative outcomes after solid organ transplantation

Abstract:

Background: Transplantation is the final step in a multi-stage process where effective communication is essential for optimal postoperative outcomes. Language discordance may provide many challenges through this process. Methods: We compared patient/graft survival, rejection, readmission, and length of hospitalization (LOS) between patients with and without limited English proficiency (LEP). Liver and kidney patients were assessed separately. Hazard ratios, linear regression, and binomial logistic regression were retrieved from a propensity matched cohort. Word clouds and thematic analysis were used to explore reasons for readmission. Results: Compared to English-speakers, patients with LEP undergoing liver transplant had a higher risk of readmission from discharge (p < 0.006), and longer LOS (p = 0.03). Kidney recipients with LEP had longer LOS (p = 0.042). Conclusion: Transplant recipients with LEP have worse postoperative outcomes. They represent a diverse population, where language is just one of many barriers encountered. Enhanced educational exposure and system-level interventions could improve clinical outcomes.