Background
Methods
Design and setting
Study population
Data source
Comorbidity
Outcome
Statistical analysis
Results
Baseline characteristics
Total Cohort1 | Readmitted | Time to readmission, days, median (IQR) | Unchanged diagnosis2 | |
---|---|---|---|---|
Median age, years (IQR) | 75 (69-82) | 75 (70-82) | – | – |
Age groups (years) | ||||
65-75 | 44,467 (47.7%) | 19.7% | 8 (3-16) | 30.8% |
76-85 | 32,767 (35.1%) | 21.1% | 8 (3-17) | 23.8% |
86+ | 16,072 (17.2%) | 20.4% | 8 (3-16) | 22.1% |
Sex, n(%) | ||||
Male | 46,196 (49.5%) | 22.2% | 8 (3-16) | 27.5% |
Female | 47,110 (50.5%) | 18.5% | 8 (3-16) | 25.9% |
Charlson Comorbidity Index | ||||
0 | 34,672 (37.2%) | 14.1% | 7 (2-15) | 30.2% |
1-2 | 36,421 (39.0%) | 20.4% | 8 (3-16) | 26.6% |
3+ | 22,213 (23.8%) | 30.0% | 8 (3-17) | 24.4% |
Marital Status | ||||
Married | 46,965 (50.3%) | 20.5% | 8 (3-6) | 28.5% |
Not Married | 46,330 (49.7%) | 20.1% | 8 (3-16) | 25.0% |
Unknown | 11 (0.01%) | 0.0% | – | – |
Diseases of the cardiovascular system | 13,038 (13.9%) | 19.1% | 9 (4-17) | 45.3% |
Angina Pectoris | 1901 (2.0%) | 17.7% | 10 (4-18) | 33.0% |
Atrial fibrillation | 7187 (7.7%) | 19.3% | 10 (4-18) | 59.3% |
Deep vein thrombosis | 1324 (1.4%) | 15.6% | 6 (2-13) | 16.4% |
Hypertension | 1622 (1.7%) | 15.7% | 7 (3-18) | 21.7% |
Heart failure | 1004 (1.1%) | 29.8% | 8 (3-16) | 34.1% |
Diseases of the respiratory system | 3653 (3.9%) | 29.4% | 9 (3-17) | 37.8% |
COPD | 3088 (3.3%) | 29.0% | 9 (3-17) | 42.4% |
Respiratory failure | 565 (0.6%) | 31.5% | 10 (2-18) | 14.6% |
Diseases of the nervous system | 2091 (2.2%) | 12.2% | 7 (2-17) | 26.8% |
TIA | 1441 (1.5%) | 10.6% | 6 (1-15) | 24.2% |
Epilepsy | 650 (0.7%) | 15.7% | 11 (2-20) | 29.4% |
Endocrine and nutritional diseases | 2765 (3.0%) | 24.9% | 7 (2-15) | 21.5% |
Diabetes | 598 (0.6%) | 22.4% | 8 (2-17) | 19.4% |
Dehydration | 2167 (2.3%) | 25.5% | 7 (3-14) | 22.1% |
Diseases of the digestive system | 1962 (2.2%) | 23.4% | 6 (2-14) | 19.4% |
Dyspepsia | 358 (0.4%) | 15.6% | 7.5 (3-14.5) | 7.1% |
Esophagitis | 53 (0.1%) | 17.0% | 5 (1-14) | 22.2% |
Constipation | 1502 (1.6%) | 25.7% | 5.5 (2-14) | 21.5% |
Ulcer without bleeding | 49 (0.1%) | 16.3% | 4.5 (2-11) | 0% |
Hematological diseases | ||||
Anemia | 4168 (4.5%) | 32.8% | 12 (6-20) | 42.5% |
Infectious disease | 7600 (8.1%) | 23.2% | 6 (2-14) | 22.7% |
Erysipelas | 769 (0.8%) | 21.9% | 7 (3-17) | 31.6% |
Gastroenteritis | 652 (0.7%) | 21.8% | 4 (1-13) | 15.5% |
Pneumonia | 2711 (2.9%) | 23.5% | 6 (2-14) | 28.7% |
Urinary Tract Infection | 3468 (3.7%) | 23.6% | 6 (2-14) | 17.3% |
Spinal disease/arthritis | 1194 (1.3%) | 17.7% | 6 (3-13) | 15.6% |
Back Pain | 1028 (1.1%) | 19.0% | 6 (2-12) | 16.4% |
Arthritis | 166 (0.2%) | 10.2% | 7 (4-21) | 5.9% |
Mental and behavioral disorders | ||||
Misuse of drugs or alcohol | 1078 (1.2%) | 17.2% | 8 (2-15) | 16.2% |
R-diagnoses3 | 27,875 (29.8%) | 21.4% | 7 (3-15) | 22.7% |
Chest pain | 4157 (4.5%) | 15.8% | 9 (4-19) | 18.2% |
Dyspnea | 2450 (2.6%) | 26.7% | 8 (3-15) | 18.7% |
Fever | 688 (0.7%) | 32.4% | 5 (2-14) | 17.5% |
Headache | 569 (0.6%) | 15.6% | 9 (4-19) | 5.6% |
Pains in neuromuscular system | 1035 (1.1%) | 16.3% | 7 (2-15) | 6.5% |
Abdominal pain | 4920 (5.3%) | 21.6% | 6 (2-14) | 24.9 |
Other pain | 1247 (1.3%) | 22.1% | 7 (2.5-15) | 11.2% |
Vertigo | 1986 (2.1%) | 14.5% | 7 (3-15) | 16.0% |
Other R-diagnoses | 10,823 (11.6%) | 23.5% | 7 (2-15) | 28.2% |
Z-diagnoses4 | 24,392 (26.1%) | 17.1% | 8 (3-17) | 18.9% |
Malignancy | 1526 (1.6%) | 28.4% | 10 (4-17) | 18.4% |
Central-nervous diseases | 1841 (2.0%) | 13.4% | 7 (2-17) | 8.5% |
Heart diseases | 3297 (3.5%) | 15.8% | 6 (1-14) | 10.1% |
Myocardial infarction | 5705 (6.1%) | 14.3% | 10 (4-18) | 21.0% |
Rehabilitation | 8037 (8.6%) | 18.1% | 7 (2-16) | 25.0% |
Other Z-diagnoses | 3986 (4.3%) | 17.7% | 7 (2-16) | 8.4% |
Mortality
Readmission rate
Age, sex, marital status and comorbidity burden
Unadjusted HR (95% CI) | Adjusted2 HR (95% CI) | |
---|---|---|
Age1 | 1.03 (1.01-1.05) | 1.01 (0.99-1.03) |
Sex | ||
Female | Reference | Reference |
Male | 1.23 (1.19-1.26) | 1.17 (1.13-1.20) |
Charlson Comorbidity Index | ||
0 | Reference | Reference |
1-2 | 1.50 (1.44-1.55) | 1.49 (1.43-1.54) |
3+ | 2.33 (2.25-2.42) | 2.28 (2.20-2.37) |
Marital Status | ||
Married | Reference | Reference |
Not Married | 1.02 (1.00-1.05) | 1.03 (1.00-1.07) |
Discharge diagnoses
Unadjusted HR (95% CI) | Adjusted HR (95% CI)1 | |
---|---|---|
Diseases of the cardiovascular system | ||
Angina Pectoris | 0.84 (0.76-0.94) | 0.83 (0.75-0.93) |
Atrial fibrillation | 0.93 (0.88-0.98) | 1.05 (1.00-1.11) |
Deep vein thrombosis | 0.75 (0.65-0.86) | 0.82 (0.71-0.94) |
Hypertension | 0.74 (0.66-0.84) | 0.86 (0.76-0.97) |
Heart failure | 1.56 (1.39-1.75) | 1.26 (1.12-1.41) |
Diseases of the respiratory system | ||
COPD | 1.51 (1.41-1.62) | 1.33 (1.25-1.43) |
Respiratory failure | 1.74 (1.51-2.02) | 1.55 (1.34-1.79) |
Diseases of the nervous system | ||
TIA | 0.49 (0.42-0.58) | 0.54 (0.46-0.63) |
Epilepsy | 0.74 (0.61-0.90) | 0.71 (0.59-0.86) |
Endocrine and nutritional diseases | ||
Diabetes | 1.12 (0.95-1.33) | 0.90 (0.76-1.07) |
Dehydration | 1.35 (1.24-1.47) | 1.28 (1.17-1.39) |
Diseases of the digestive system | ||
Dyspepsia | 0.75 (0.57-0.97) | 0.80 (0.62-1.04) |
Esophagitis | 0.82 (0.43-1.58) | 0.81 (0.42-1.55) |
Constipation | 1.34 (1.20-1.47) | 1.26 (1.14-1.39) |
Ulcer without bleeding | 0.80 (0.40-1.59) | 0.77 (0.39-1.55) |
Hematological diseases | ||
Anemia | 1.72 (1.63-1.82) | 1.45 (1.38-1.54) |
Infectious disease | ||
Erysipelas | 1.08 (0.93-1.26) | 1.08 (0.93-1.25) |
Gastroenteritis | 1.10 (0.93-1.30) | 1.10 (0.93-1.29) |
Pneumonia | 1.22 (1.13-1.32) | 1.15 (1.06-1.25) |
Urinary Tract Infection | 1.21 (1.13-1.30) | 1.15 (1.07-1.24) |
Spinal disease/arthritis | ||
Back Pain | 0.93 (0.81-1.07) | 1.02 (0.88-1.17) |
Arthritis | 0.47 (0.29-0.76) | 0.51 (0.31-0.81) |
Mental and behavioral disorders | ||
Misuse of drugs and alcohol | 0.83 (0.72-0.96) | 0.85 (0.74-0.99) |
R-diagnoses2 | ||
Chest pain | 0.74 (0.68-0.80) | 0.76 (0.70-0.82) |
Dyspnea | 1.38 (1.28-1.49) | 1.25 (1.15-1.35) |
Fever | 1.77 (1.55-2.02) | 1.52 (1.33-1.73) |
Headache | 0.74 (0.60-0.91) | 0.80 (0.65-0.99) |
Pains in neuromuscular system | 0.79 (0.68-0.92) | 0.80 (0.69-0.94) |
Abdominal pain | 1.08 (1.02-1.15) | 1.12 (1.05-1.19) |
Other pain | 1.11 (0.99-1.25) | 1.09 (0.96-1.22) |
Vertigo | 0.68 (0.61-0.77) | 0.73 (0.65-0.82) |
Other R-diagnoses | 1.21 (1.16-1.27) | 1.18 (1.13-1.23) |
Z-diagnoses3 | ||
Malignancy | 1.46 (1.32-1.60) | 1.51 (1.37-1.66) |
Central-nervous diseases | 0.63 (0.55-0.71) | 0.66 (0.58-0.75) |
Heart diseases | 0.75 (0.69-0.82) | 0.81 (0.74-0.88) |
Myocardial infarction | 0.66 (0.61-0.70) | 0.67 (0.62-0.72) |
Rehabilitation | 0.87 (0.83-0.92) | 0.88 (0.84-0.93) |
Other Z-diagnoses | 0.86 (0.79-0.93) | 0.88 (0.82-0.95) |