Outcomes included discharge disposition and number and timing of readmissions. Covari-ates included demographics, donor age, graft type, MELD, etiology of liver disease, Charlson Comorbidity Index (CCI), pre-transplant depression, pretransplant pain and opioid use, ischemia time, and self-reported pre-transplant disability. Covariates were evaluated using the following multivariable models:

logistic regression for discharge disposition after transplant, competing risk Cox proportional-hazards regression for time to rehospitalization, IWR-1 and negative binomial regression for number of rehospitalizations (using followup time as an offset). Results: Of 1085 transplant recipients, 679 (63%) were discharged home, 233 (21%) required long-term acute care, and 61 (5%) required nursing home care. The statistically significant predictors of long-term care requirements included age at transplant (OR=1.04 per year, 95%CI=1.02,1.06),

female gender (OR=1.79, 95%CI=1.23,2.63), depression pre-transplant (OR=1.71, 95%CI=1.07,2.60), and MELD at transplant (OR=1.08,95%,CI=1.05,1.10). Discharge to a location other than home was associated with significantly decreased time to rehospitalization (median time 17 vs. 71 days p<0.01). Over the period of followup, 74% of patients were rehospitalized. The median number of rehospitalization was 2 (IQR=0,4), with a median of 4.6 years of follow-up (IQR=1.8,7.6). Excluding disposition after transplant, the only significant predictor Selleck Dabrafenib of time from discharge to rehospitalization was the CCI (HR=1.07 per point, p<0.01). There was a non-significant trend towards pretransplant depression predicting shorter time to readmis-sion (HR=1.18, p=0.07). The number of rehospitalizations were associated with pre-transplant depression (IRR=1.18, CI=1.17,1.18), pre-transplant opioid use (IRR=1.30, CI=1.29,1.31), warm ischemia time (IRR per minute=1.003, 1.00,1.00), CCI (IRR=1.16, CI=1.15,1.16),

and etiology of liver disease. Conclusions: Pre-transplant depression and pre-transplant opioid use are potentially modifiable risk factors for increased healthcare utilization after liver transplantation. Disclosures: The following people have nothing to disclose: Shari S. Rogal, Gautam Mank-aney, Viyan Udawatta, Christopher B. Hughes, Amit D. Tevar, Mark Sturdevant, Abhinav Humar, Andrea DiMartini Background Pneumococcal disease Tryptophan synthase is a leading cause of vaccine- preventable illness and death in the United States. The Centers for Disease Control and Prevention (CDC) recommends vaccination of any patient with cirrhosis between age 2 and 64 and any adult older than 65. Our objective is to determine pneumococcal vaccination (Pneumovax) prevalence in patients with liver cirrhosis. Methods This was a retrospective study utilizing the “Explorys” database, an open private cloud based platform that electronically integrates non-identified patient data used by 14 major healthcare systems.