Measuring readmissions: focus on the time factor

Heggestad, Torhild; Lilleeng, Solfrid

doi:10.1093/intqhc/mzg019

Cited by 43 publications

(28 citation statements)

References 24 publications

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“…Several aspects of the completeness and quality of the NPR register have been documented. For example, high agreement was reported recently by a record linkage study to cross-check deaths in the patient register with deaths in the population register (Heggestad & Lilleeng, 2003).…”

Section: Discussionmentioning

confidence: 70%

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): Data from the National Patient Register and the Causes of Death Register

Reas

Kjelsås

Heggestad

et al. 2005

Int. J. Eat. Disord.

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Section: Discussionmentioning

confidence: 70%

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): Data from the National Patient Register and the Causes of Death Register

Reas

Kjelsås

Heggestad

et al. 2005

Int. J. Eat. Disord.

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“…We have validated the use of CPT code 99291 in a prior study to identify patients in the RDPR dataset who are admitted to an ICU [21]. The 30-day time point for hospital readmission is frequently utilized in outcome research [48–51], and is the statistically optimal approach for readmission rates [52, 53]. From our validation data, it appears that the Master Death File accurately captures postdischarge mortality in our population.…”

Section: Discussionmentioning

confidence: 99%

Nucleated red blood cells, critical illness survivors and postdischarge outcomes: a cohort study

Purtle

Horkan

Moromizato³

et al. 2017

Crit Care

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BackgroundLittle is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge.MethodsWe performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare. We studied 2878 patients, age ≥ 18 years, who received critical care between 2011 and 2015 and survived hospitalization. The exposure of interest was nucleated red blood cells occurring from 2 days prior to 7 days after critical care initiation. The primary outcome was mortality in the 90 days following hospital discharge. Secondary outcome was unplanned 30-day hospital readmission. Adjusted odds ratios were estimated by multivariable logistic regression models with inclusion of covariate terms thought to plausibly interact with both nucleated red blood cells and outcome. Adjustment included age, race (white versus nonwhite), gender, Deyo–Charlson Index, patient type (medical versus surgical), sepsis and acute organ failure.ResultsIn patients who received critical care and survived hospitalization, the absolute risk of 90-day postdischarge mortality was 5.9%, 11.7%, 15.8% and 21.9% in patients with 0/μl, 1–100/μl, 101–200/μl and more than 200/μl nucleated red blood cells respectively. Nucleated red blood cells were a robust predictor of postdischarge mortality and remained so following multivariable adjustment. The fully adjusted odds of 90-day postdischarge mortality in patients with 1–100/μl, 101–200/μl and more than 200/μl nucleated red blood cells were 1.77 (95% CI, 1.23–2.54), 2.51 (95% CI, 1.36–4.62) and 3.72 (95% CI, 2.16–6.39) respectively, relative to patients without nucleated red blood cells. Further, the presence of nucleated red blood cells is a significant predictor of the odds of unplanned 30-day hospital readmission.ConclusionIn critically ill patients who survive hospitalization, the presence of nucleated red blood cells is a robust predictor of postdischarge mortality and unplanned hospital readmission.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1724-z) contains supplementary material, which is available to authorized users.

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“…We have previously validated the use of CPT code 99291 to identify patients in the RDPR administrative dataset who are admitted to an ICU (30). The 30-day time frame for hospital readmission is commonly used in outcomes research (70)(71)(72)(73), has been demonstrated to be the statistically optimal choice for identifying readmission rates (74,75), and is most relevant for targeting interventions and for public reporting (76). Our study compliments observations regarding the risk of the development of ESRD related to the severity of AKI (5).…”

Section: Discussionmentioning

confidence: 99%

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

Horkan

Purtle

Mendu

et al. 2015

Critical Care Medicine

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Patients who suffer acute kidney injury are among a high-risk group of ICU survivors for adverse outcomes. In patients treated with critical care who survive hospitalization, acute kidney injury is a robust predictor of subsequent unplanned hospital readmission. In critical illness survivors, acute kidney injury is also associated with the odds of 30-day postdischarge mortality and the risk of subsequent end-stage renal disease.

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Measuring readmissions: focus on the time factor

Abstract: When unplanned readmissions are used as an outcome indicator, the measure is susceptible to the choice of time interval. The operative characteristics must be interpreted in the context of where it is intended that the indicator should be used.

Cited by 43 publications

References 24 publications

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): Data from the National Patient Register and the Causes of Death Register

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): Data from the National Patient Register and the Causes of Death Register

Nucleated red blood cells, critical illness survivors and postdischarge outcomes: a cohort study

The Association of Acute Kidney Injury in the Critically Ill and Postdischarge Outcomes

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