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Observational Study
. 2021 Jul;290(1):157-165.
doi: 10.1111/joim.13241. Epub 2021 Feb 5.

Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19

I Yeo  1   2 , S Baek  3 , J Kim  1 , H Elshakh  3 , A Voronina  3 , M S Lou  3 , J Vapnik  3 , R Kaler  3 , X Dai  1 , S Goldbarg  1
Affiliations
Observational Study

Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19

I Yeo et al. J Intern Med. 2021 Jul.

Abstract

Background: There are limited data on the characteristics of 30-day readmission after hospitalization with coronavirus disease 2019 (COVID-19).

Objectives: To examine the rate, timing, causes, predictors and outcomes of 30-day readmission after COVID-19 hospitalization.

Methods: From 13 March to 9 April 2020, all patients hospitalized with COVID-19 and discharged alive were included in this retrospective observational study. Multivariable logistic regression was used to identify the predictors of 30-day readmission, and a restricted cubic spline function was utilized to assess the linearity of the association between continuous predictors and 30-day readmission.

Results: A total of 1062 patients were included in the analysis, with a median follow-up time of 62 days. The mean age of patients was 56.5 years, and 40.5% were women. At the end of the study, a total of 48 (4.5%) patients were readmitted within 30 days of discharge, and a median time to readmission was 5 days. The most common primary diagnosis of 30-day readmission was a hypoxic respiratory failure (68.8%) followed by thromboembolism (12.5%) and sepsis (6.3%). The patients with a peak serum creatinine level of ≥1.29 mg/dL during the index hospitalization, compared to those with a creatinine of <1.29 mg/dL, had 2.4 times increased risk of 30-day readmission (adjusted odds ratio: 2.41; 95% CI: 1.23-4.74). The mortality rate during the readmission was 22.9%.

Conclusion: With 4.5% of the thirty-day readmission rate, COVID-19 survivors were readmitted early after hospital discharge, mainly due to morbidities of COVID-19. One in five readmitted COVID-19 survivors died during their readmission.

Keywords: COVID-19; epidemiology; patient readmission; readmission mortality; readmission predictor.

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Conflict of interest statement

All authors report no potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study Baseline Cohort. Abbreviations: COVID‐19, coronavirus disease 2019.
Figure 2
Figure 2
Timing of 30‐Day Readmission by Postdischarge Day in Patients Readmitted after Index Hospitalization Related to COVID‐19. Amongst those readmitted, 50% and 60.4% were readmitted within 5 and 7 days of discharge, respectively. COVID‐19, coronavirus disease 2019.
Figure 3
Figure 3
Primary Diagnoses of 30‐Day Readmission after Index Hospitalization Related to COVID‐19.
Figure 4
Figure 4
Association between Peak Serum Creatinine Level during Index Hospitalization Related to COVID‐19 and 30‐Day Readmission. A restricted cubic spline function was used adjusting for covariates including age, body mass index, hypertension, diabetes mellitus, congestive heart failure, coronary artery disease, atrial fibrillation, chronic obstructive pulmonary disease /asthma, lactate dehydrogenase, troponin and discharge disposition.
Figure 5
Figure 5
Thirty‐Day Readmission after Hospital Discharge in Patients with Peak Serum Creatinine Levels of ≥1.29 mg/dL and <1.29 mg/dL from Index Hospitalization Related to COVID‐19. The shaded areas represent 95% confidence intervals. P < 0.001.
See this image and copyright information in PMC

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