Key result
Median Rothman Index at discharge was significantly lower in patients readmitted within 30 days compared to matched controls (70 vs 75.5, p=0.029), with scores ≤58.9 predicting a ≥50% readmission risk.
Why the study?
The study was designed to determine the utility of the Rothman Index in assessing 30-day readmission rates in postoperative gynecologic oncology service patients.
Does the Rothman Index at discharge predict 30-day readmission in postoperative gynecologic oncology patients?
Case-Control (n=72)
No
Does the Rothman Index at discharge predict 30-day readmission in postoperative gynecologic oncology patients?
Absolute Event Rate: 70% vs 75.5%
p-value: p=0.029
The Rothman Index at discharge is a useful tool for predicting 30-day readmission risk in postoperative gynecologic oncology patients.
Lower discharge Rothman Index was associated with 30-day readmission; hypothesis-generating and requires prospective validation before guiding discharge decisions.
Background: The Rothman Index (RI) is a previously validated, continuously computed score derived from 26 clinical measures that assesses a patient's clinical status. It has been used as a prognostic indicator in the intensive care setting and has been incorporated into the electronic medical record. This study was designed to determine its utility in assessing 30-day readmission rates in postoperative gynecologic oncology service patients. Methods: In this retrospective case-control study, gynecologic oncology service surgical patients readmitted within 30 days of discharge (cases) were matched 1:2 by procedure, diagnosis, age and comorbidities to non-readmitted gynecologic oncology surgical patients (controls). All procedures were performed at one center by a single surgeon. Rothman Index values were obtained immediately postoperative (RIp) and before discharge (RId), and the difference between these values was calculated (RIc). Rothman Index scores were compared between cases and controls. Results: In total, 24 cases were matched to 48 controls. The mean age of all study participants was 56 years. The RId was significantly different between groups, with median RId of 70 for readmitted subjects and 75.5 for controls (P = .029). Binomial regression of readmission on RI revealed an RId of 58.9 or less was associated with at least 50% likelihood of readmission (P = .017). Cases and controls did not significantly differ based on RIp or RIc, and were similar with respect to risk factors including diabetes, smoking, and BMI. Conclusion: Delaying discharge for patients with RI below a designated threshold may reduce gynecologic oncology postoperative readmission rates.
No takes yet. Share an insight, caveat, or question.
Butz et al. (2019) conducted a case-control in Postoperative gynecologic oncology (n=72). Rothman Index at discharge (RId) vs. Higher Rothman Index scores was evaluated on Median Rothman Index at discharge (RId) (p=0.029). Median Rothman Index at discharge was significantly lower in patients readmitted within 30 days compared to matched controls (70 vs 75.5, p=0.029), with scores ≤58.9 predicting a ≥50% readmission risk.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: