Taha Mohammad, Pal Aroop, Mahnken Jonathan D, Rigler Sally K
Division of General and Geriatric Medicine, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
Department of Biostatistics, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
Int J Qual Health Care. 2014 Jun;26(3):271-7. doi: 10.1093/intqhc/mzu038. Epub 2014 Apr 15.
To create a simple readmission risk-prediction tool that can be generated easily at the bedside by physicians, nurses, care coordinators and discharge planners.
Retrospective cohort study.
Tertiary academic medical center.
Inpatients aged 18 and older on general internal medicine services.
Predictor variables included age, prior hospitalization, high-risk diagnoses, high-risk medications, polypharmacy, depression, use of palliative care and a cumulative score summing these factors (readmission risk score-RRS). The main outcome measure was 30-day readmission. Predictive values were calculated.
Readmission increased linearly from 4.9% of those whose RRS score was 0-37.5% of those with highest risk scores (P = 0.0002). We derived a simple formula for readmission risk as 8 and 4% more for each additional readmission risk factor. The positive predictive value for RRS >0 was low, while the negative predictive value for this cutoff was 95%.
An easily calculated 7-point score can be used to estimate readmission risk. This tool may be particularly useful for identifying lower risk patients who may not require intensive intervention, thus aiding in appropriate targeting of resources.
创建一种简单的再入院风险预测工具，使医生、护士、护理协调员和出院计划制定者能够在床边轻松生成。
回顾性队列研究。
三级学术医疗中心。
普通内科服务中年龄在18岁及以上的住院患者。
预测变量包括年龄、既往住院史、高危诊断、高危药物、多重用药、抑郁症、姑息治疗的使用以及将这些因素相加的累积评分（再入院风险评分-RRS）。主要结局指标是30天再入院情况。计算预测值。
再入院率从RRS评分为0的患者的4.9%呈线性增加至风险评分最高的患者的37.5%（P = 0.0002）。我们得出了一个简单的再入院风险公式，即每增加一个再入院风险因素，风险增加8%和4%。RRS>0的阳性预测值较低，而该临界值的阴性预测值为95%。
一个易于计算的7分评分可用于估计再入院风险。该工具对于识别可能不需要强化干预的低风险患者可能特别有用，从而有助于合理分配资源。
