Key result
Thirty-day readmission is linked to ~106% higher all-cause mortality over two years.
Why the study?
Readmission within 30 days is used as a standard quality metric, but its association with short- and long-term mortality was unclear.
Does hospital readmission within 30 days predict higher all-cause mortality in patients admitted to an inpatient medicine service?
Cohort (n=2,353)
No
Does hospital readmission within 30 days predict higher all-cause mortality in patients admitted to an inpatient medicine service?
Hazard Ratio: 2.06 (95% CI 1.55–2.74)
Absolute Event Rate: 41.2% vs 21.6%
p-value: p=<0.001
Thirty-day hospital readmission is an independent risk factor for all-cause mortality persisting for at least two years, suggesting it is a marker of long-term risk rather than just a short-term quality metric.
May flag high-risk medicine inpatients for intensified monitoring; leaves open whether targeted interventions improve survival.
Introduction Readmission within 30 days is used as a standard quality metric for hospitalized patients. We hypothesized that patients who get readmitted within 30 days may have higher short- and long-term mortality. Material and Methods Using administrative data, we retrospectively analyzed 2,353 patients admitted to inpatient medicine service over a period of one year. The patients were matched for diagnostic group (DRG) and severity index (SI) using nearest propensity scores in a 2:1 ratio between non-readmissions (NRA) to readmissions (RA) patients. Results There was no statistically significant difference in the groups between age, sex, length of stay (LOS), race, and ethnicity. The hazard model yielded a hazard ratio (HR) of 2.06 for 30-day readmissions (95% CI of 1.55, 2.74; p=<0.001). The survival probability at 6, 12, 18, and 24 months was consistently greater for NRA patients. Conclusions Thirty-day readmissions are an independent risk factor for all-cause mortality which persists for at least two years independent of DRG and SI.
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Shaw et al. (2020) conducted a cohort in Hospitalized patients (internal medicine) (n=2,353). 30-day hospital readmission vs. No 30-day hospital readmission was evaluated on All-cause mortality (HR 2.06, 95% CI 1.55-2.74, p=<0.001). Thirty-day hospital readmission was associated with an approximately two-fold increased risk of all-cause mortality (HR 2.06) that persisted for up to two years.
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