Thirty-Day Hospital Readmissions: A Predictor of Higher All-cause Mortality for Up to Two Years

Jawaid A Shaw; Spiro Stiliannoudakis; Rabia Qaiser; Erynn Layman; Adam Sima; Asghar Ali

doi:10.7759/cureus.9308

Thirty-Day Hospital Readmissions: A Predictor of Higher All-cause Mortality for Up to Two Years

Cureus. 2020 Jul 21;12(7):e9308. doi: 10.7759/cureus.9308.

Authors

Jawaid A Shaw¹, Spiro Stiliannoudakis², Rabia Qaiser³, Erynn Layman³, Adam Sima⁴, Asghar Ali³

Affiliations

¹ Internal Medicine, Virginia Commonwealth University, Richmond, USA.
² Biostatistics, Virginia Commonwealth University, Richmond, USA.
³ Internal Medicine, Hunter Holmes McGuire VA Medical Center, Virginia Commonwealth University, Richmond, USA.
⁴ Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, USA.

Abstract

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.

Keywords: mortality; readmissions; two years; veteran affairs.