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. 2022 Oct;13(5):1119-1125.
doi: 10.1007/s41999-022-00687-5. Epub 2022 Aug 30.

Derivation and validation of a 90-day unplanned hospital readmission score in older patients discharged form a geriatric ward

Moustapha Dramé  1   2 , Victor Hombert  3 , Eléonore Cantegrit  3 , Emeline Proye  3 , Lidvine Godaert  4
Affiliations

Derivation and validation of a 90-day unplanned hospital readmission score in older patients discharged form a geriatric ward

Moustapha Dramé et al. Eur Geriatr Med. 2022 Oct.

Abstract

Purpose: To derive and validate a 90-day unplanned hospital readmission (UHR) score based on information available to non-hospital based care providers.

Methods: Retrospective longitudinal study with cross-validation method. Participants were older adults (≥ 65 years) admitted to a geriatric short-stay department in a general hospital in France. Patients were split into a derivation cohort and a validation cohort. We recorded demographic information, medical history, and concurrent clinical characteristics. The main outcome was 90-day UHR. Data obtained from hospital discharge letters were used in a logistic regression model to construct a predictive score, and to identify risk groups for 90-day UHR.

Results: In total, 750 and 250 aged adults were included in both the derivation and the validation cohorts. Mean age was 87.2 ± 5.2 years, most were women (68.1%). Independent risk factors for 90-day UHR were: use of mobility aids (p = .02), presence of dementia syndrome (p = .02), history of recent hospitalisation (p = .03), and discharge to domiciliary home (p = .005). From these four risk factors, three groups were determined: low-risk group (score < 4), medium-risk group (score between 4 and 6), and high-risk group (score ≥ 6). In the derivation cohort the 90-day UHR rates increased significantly across risk groups (14%, 22%, and 30%, respectively). The 90-day UHR score had the same discriminant power in the derivation cohort (c-statistic = 0.63) as in the validation cohort (c-statistic = 0.63).

Conclusions: This score makes it possible to identify aged adults at risk of 90-day UHR and to target multidisciplinary interventions to limit UHR for patients discharged from a Geriatric Short-Stay Unit.

Keywords: Aged adults; Cross-validation; Risk factors; Unplanned hospital readmission.

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Conflict of interest statement

The authors declare no competing interest directly or indirectly related to this work.

References

    1. Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M, et al. Risk prediction models for hospital readmission: a systematic review. JAMA. 2011;306:1688–1698. doi: 10.1001/jama.2011.1515. - DOI - PMC - PubMed
    1. Mathew SA, Gane E, Heesch KC, McPhail SM. Risk factors for hospital re-presentation among older adults following fragility fractures: a systematic review and meta-analysis. BMC Med. 2016;14:136. doi: 10.1186/s12916-016-0671-x. - DOI - PMC - PubMed
    1. Damiani G, Salvatori E, Silvestrini G, Ivanova I, Bojovic L, Iodice L, et al. Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review. Clin Interv Aging. 2015;2015(10):237–245. doi: 10.2147/CIA.S71165.eCollection. - DOI - PMC - PubMed
    1. Howie-Esquivel J, Spicer JG. Association of partner status and disposition with rehospitalization in heart failure patients. Am J Crit care. 2012;21:e65–73. doi: 10.4037/ajcc2012382. - DOI - PubMed
    1. Schwarz KA, Elman CS. Identification of factors predictive of hospital readmissions for patients with heart failure. Heart Lung. 2003;32:88–99. doi: 10.1067/mhl.2003.15. - DOI - PubMed