Ontology highlight
ABSTRACT: Objectives
Limited studies have identified predictors of early and late hospital readmissions in Australian healthcare settings. Some of these predictors may be modifiable through targeted interventions. A recent study has identified malnutrition as a predictor of readmissions in older patients but this has not been verified in a larger population. This study investigated what predictors are associated with early and late readmissions and determined whether nutrition status during index hospitalisation can be used as a modifiable predictor of unplanned hospital readmissions.Design
A retrospective cohort study.Setting
Two tertiary-level hospitals in Australia.Participants
All medical admissions ≥18 years over a period of 1 year.Outcomes
Primary objective was to determine predictors of early (0-7 days) and late (8-180 days) readmissions. Secondary objective was to determine whether nutrition status as determined by malnutrition universal screening tool (MUST) can be used to predict readmissions.Results
There were 11 750 (44.8%) readmissions within 6 months, with 2897 (11%) early and 8853 (33.8%) late readmissions. MUST was completed in 16.2% patients and prevalence of malnutrition during index admission was 31%. Malnourished patients had a higher risk of both early (OR 1.39, 95% CI 1.12 to 1.73) and late readmissions (OR 1.23, 95% CI 1.06 to 128). Weekend discharges were less likely to be associated with both early (OR 0.81, 95% CI 0.74 to 0.91) and late readmissions (OR 0.91, 95% CI 0.84 to 0.97). Indigenous Australians had a higher risk of early readmissions while those living alone had a higher risk of late readmissions. Patients ≥80 years had a lower risk of early readmissions while admission to intensive care unit was associated with a lower risk of late readmissions.Conclusions
Malnutrition is a strong predictor of unplanned readmissions while weekend discharges are less likely to be associated with readmissions. Targeted nutrition intervention may prevent unplanned hospital readmissions.Trial registration
ANZCTRN 12617001362381; Results.
SUBMITTER: Sharma Y
PROVIDER: S-EPMC6020977 | biostudies-literature |
REPOSITORIES: biostudies-literature