Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units

Lanièce, Isabelle; Couturier, Pascal; Dramé, Moustapha; Gavazzi, G.; Lehman, S Nusinoff; Jolly, Damien; Voisin, Thierry; Lang, Pierre Olivier; Jovenin, Nicolas; Gauvain, J. B.; Novella, Jean‐Luc; Saint-Jean, Olivier; Blanchard, F.

doi:10.1093/ageing/afn093

Cited by 142 publications

(102 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the study of Laniece et al functional disability was relevant to explain the risk of early readmissions in a cohort of patients aged 75 and older [23]. However, in this study, functional disability as assessed by the Barthel index was not associated with readmission, in agreement with the findings of Alarcon et al, who showed that limited activities of daily living were only predictive of hospital mortality and prolonged stay [24].…”

Section: Discussionsupporting

confidence: 89%

Risk factors for hospital readmission of elderly patients

Franchi

Nobili

Mari

et al. 2013

European Journal of Internal Medicine

View full text Add to dashboard Cite

Background: The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards. Methods: Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge. Results: Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission.Conclusions: The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases.

show abstract

Section: Discussionsupporting

confidence: 89%

Risk factors for hospital readmission of elderly patients

Franchi

Nobili

Mari

et al. 2013

European Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…We did not capture readmissions to outside hospitals, which account for 22% to 24% of all readmissions in prior studies, and therefore have underestimated the readmission rate in our population. 2,8 However, by limiting our data to 2 hospitals within 1 institution, we were able to include more detailed patient level data, which is not accurately available in other large databases. Also, while studies of risk factors in a managed care population (such as within Medicare, the Veterans Affairs medical centers, or countries with national integrated medical records) are able to capture all readmissions, this study is the first to evaluate readmissions risk factors in a truly heterogeneous U.S. inpatient medicine population without limitation by age or payer status.…”

Section: Discussionmentioning

confidence: 99%

“…A few clinical risk factors (such as age, number of prior admissions, and comorbidities) have been well defined in subgroups of general medicine inpatients. [6][7][8][9][10][11][12] Likewise, interventions aiming to reduce readmissions have also focused on subgroups, excluding a large portion of hospitalized patients (for example, non-English speakers and younger patients). [13][14][15][16][17][18][19][20] Other data have been derived in veterans or within non-US populations that have inherently different payer, race, ethnicity, and primary language composition, and may not be applicable outside those settings.…”

mentioning

confidence: 99%

“…[13][14][15][16][17][18][19][20] Other data have been derived in veterans or within non-US populations that have inherently different payer, race, ethnicity, and primary language composition, and may not be applicable outside those settings. 7,8,10,11,21 Lastly, little is known regarding risk that may be associated with operational factors, such as weekend discharge or admission source. As a result, there are few data describing the clinical, operational, and demographic factors associated with readmission in a heterogeneous population of hospitalized general medicine patients-the patient population of most generalists in the United States.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Redefining readmission risk factors for general medicine patients

Allaudeen

Vidyarthi

Maselli

et al. 2010

Journal of Hospital Medicine

195

155

View full text Add to dashboard Cite

BACKGROUND:Readmissions are costly both financially for our healthcare system and emotionally for our patients. Identifying factors that increase risk for readmissions may be helpful to focus resources to optimize the discharge process and reduce avoidable readmissions.OBJECTIVE:To identify factors associated with readmission within 30 days for general medicine patients.METHODS:We performed a retrospective observational study of an administrative database at an urban 550‐bed tertiary care academic medical center. Cohort patients were discharged from the general medicine service over a 2‐year period from June 1, 2006, to May 31, 2008. Clinical, operational, and sociodemographic factors were evaluated for association with readmission.RESULTS:Our cohort included 10,359 consecutive admissions (6805 patients) discharged from the general medicine service. The 30‐day readmission rate was 17.0%. In multivariate analysis, factors associated with readmission included black race (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.24–1.65), inpatient use of narcotics (1.33; 1.16–1.53) and corticosteroids (1.24; 1.09–1.42), and the disease states of cancer (with metastasis 1.61; 1.33–1.95; without metastasis 1.95; 1.54–2.47), renal failure (1.19; 1.05–1.36), congestive heart failure (1.30; 1.09–1.56), and weight loss (1.26; 1.09–1.47). Medicaid payer status (1.15; 0.97–1.36) had a trend toward readmission.CONCLUSION:Readmission of general medicine patients within 30 days is common and associated with several easily identifiable clinical and nonclinical factors. Identification of these risk factors can allow providers to target interventions to reduce potentially avoidable readmissions. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine

show abstract

“…Early identification of those at risk may be required facilitate intervention to prevent repeat hospitalisations. 15 Another identified an 8% readmission rate within three months for patients who received full community support at the time of discharge. On subsequent readmissions, over half could be discharged home again with the remaining likely to die in hospital or require institutional long-term care.…”

Section: Conflicts Of Interest Statementmentioning

confidence: 99%