September 17, 2019
By identifying factors significantly associated with potentially avoidable readmissions (PAR), researchers created and internally validated a predictive score to signal patients at increased risk of hospital readmission within 30 days. They published their findings online in PLoS One.
“The PAR-Risk Score may help to identify high-risk patients before discharge home, and this should help healthcare providers to target complex transitional interventions that improve the coordination of care,” researchers wrote, “with the overarching goal of decreasing readmission rates.”
To create a risk score, researchers analyzed demographic data, diagnoses, lab results, and medication data for 7317 general internal medicine stays between 2011 and 2013. Of the stays, 562 were followed by a potentially avoidable hospital readmission.
The following factors were significantly associated with potentially avoidable readmissions:
- hospital admission in previous 6 months (the study identified an adjusted odds ratio of 2.3),
- diabetes with organ damage (2.2),
- metastatic carcinoma (1.9),
- chronic ischemic heart disease (1.7),
- hyperkalemia (1.4),
- cancer (1.4),
- hospital stay longer than 4 days (1.3),
- heart failure (1.3),
- hypertension (1.3),
- arrhythmia (1.3),
- opioid prescription (1.3),
- anemia (1.2), and
- acute myocardial infarction (0.6).
Researchers used the factors to create a PAR-Risk Score, which they validated retrospectively in a cohort of patients admitted in 2013 and 2014.
“The PAR-Risk Score showed an acceptable ability to discriminate patients into low, medium, and high-risk categories,” they reported. “As a next step, therefore, we think that the PAR-Risk Score should be validated externally in order to confirm the interest of its use in detecting patients at a high risk of PAR.”
Blanc AL, Fumeaux T, Stirnemann J, et al. Development of a predictive score for potentially avoidable hospital readmissions for general internal medicine patients. PLoS One. 2019 July 15;14(7):e0219348.