Trakulthong Chayanis, Phunmanee Anakapong
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Ther Clin Risk Manag. 2017 Dec 5;13:1551-1554. doi: 10.2147/TCRM.S142114. eCollection 2017.
Readmission is an indicator of quality of inpatient care. A study from Hong Kong found readmission mortality rate to be 5.1%. There are limited reports on risk factors for mortality other than co-morbid diseases in readmission patients. This study, thus, aims to evaluate risk factors for mortality during readmission.
This study was conducted at a university hospital in Thailand. The inclusion criteria were patients aged ≥15 years and readmission to internal medicine wards within 28 days after discharge. The outcome of the study was death during readmission. Risk factors for readmission mortality were analyzed using multivariate logistic regression analysis.
There were 10,389 admissions to the Department of Medicine, Khon Kaen University, of which 407 required readmission (3.90%). Of those patients, 75 (18.43%) died during readmission. There were 6 independent factors associated with death in patients who were readmitted, including advanced age (>60 years), presence of more than 2 co-morbid diseases, admission duration of >14 days, fever at previous discharge, low hemoglobin (<12 g/dL), and having undergone over 5 procedures.
Older age, co-morbid diseases, readmission duration, presence of low hemoglobin at previous discharge, and numbers of procedures at readmission were significantly associated with increased mortality risk for readmission patients.
再入院是住院治疗质量的一项指标。香港的一项研究发现再入院死亡率为5.1%。关于再入院患者中除合并症以外的死亡风险因素的报告有限。因此,本研究旨在评估再入院期间的死亡风险因素。
本研究在泰国的一家大学医院进行。纳入标准为年龄≥15岁且出院后28天内再次入住内科病房的患者。研究的结局是再入院期间死亡。使用多因素逻辑回归分析来分析再入院死亡的风险因素。
孔敬大学医学院共有10389例入院病例,其中407例需要再入院(3.90%)。在这些患者中,75例(18.43%)在再入院期间死亡。有6个独立因素与再入院患者的死亡相关,包括高龄(>60岁)、合并症超过2种、入院时间>14天、上次出院时发热、血红蛋白水平低(<12 g/dL)以及接受过5次以上手术。
高龄、合并症、再入院时长、上次出院时血红蛋白水平低以及再入院时的手术次数与再入院患者的死亡风险增加显著相关。