Background
Methods
Setting and study population
Data collection and definitions
Statistical analysis
Results
Total study population
Study population | All patients | Younger patients (<65 years) | Older patients (≥65 years) | |||||||
---|---|---|---|---|---|---|---|---|---|---|
N (%) or median (range) | Total study population | Readmission group | No readmission group |
p value* | Readmission group | No readmission group |
p value* | Readmission group | No readmission group |
p value* |
N = 940 |
N = 163 |
N = 777 |
N = 82 |
N = 403 |
N = 81 |
N = 374 | ||||
Age, in years | 64 (16–101) | 65 (17–95) | 64 (16–101) | 0.39 |
56 (17–65)
|
50 (16–65)
|
0.001
| 76 (65–95) | 77 (65–101) | 0.21 |
Sex, female | 493 (52.4) | 77 (47.2) | 416 (53.5) | 0.14 | 39 (47.6) | 214 (53.1) | 0.36 | 38 (46.9) | 202 (54.0) | 0.25 |
CCI |
2 (0–11)
|
2 (0–9)
|
2 (0–11)
|
0.04
|
2 (0–8)
|
1 (0–11)
|
0.005
| 2 (0–9) | 2 (0–9) | 0.96 |
Number of medications useda
| 5.0 (0–25) | 5.0 (0–21) | 5.0 (0–25) | 0.70 | 4.0 (0–21) | 3.0 (0–25) | 0.11 |
5.0 (0–16)
|
7.0 (0–20)
|
0.006
|
ADL dependency, yes | 44 (4.7) | 12 (7.4) | 32 (4.1) | 0.08 | 2 (2.4) | 9 (2.2) | 1.0 | 10 (12.3) | 23 (6.1) | 0.05 |
IADL dependency, yes | 55 (5.9) | 11 (6.7) | 44 (5.7) | 0.59 | 2 (2.4) | 11 (2.7) | 1.0 | 9 (11.1) | 33 (8.8) | 0.52 |
Cognitive impairmenta, yes | 79 (8.4) | 9 (5.5) | 70 (9.0) | 0.16 | 2 (2.4) | 9 (2.2) | 1.0 | 7 (8.6) | 61 (16.3) | 0.09 |
Living situation, nursing facility | 65 (6.9) | 9 (5.5) | 56 (7.2) | 0.50 | 1 (1.2) | 7 (1.7) | 1.0 | 8 (9.9) | 49 (13.1) | 0.58 |
Reason for index admission | ||||||||||
Gastro-intestinal | 226 (24.0) | 33 (20.2) | 193 (24.8) | 0.21 | 13 (15.9) | 85 (21.1) | 0.28 | 20 (24.7) | 108 (28.9) | 0.45 |
Infection | 214 (22.8) | 30 (18.4) | 184 (23.7) | 0.14 | 15 (18.3) | 77 (19.4) | 0.86 | 15 (18.5) | 107 (28.6) | 0.06 |
Malignancy |
167 (17.8)
|
54 (33.1)
|
113 (14.5)
| <0.001
|
28 (34.1)
|
59 (14.6)
| <0.001
|
26 (32.1)
|
54 (14.4)
| <0.001
|
Inflammatory | 83 (8.8) | 16 (9.8) | 67 (8.6) | 0.63 | 12 (14.6) | 45 (11.2) | 0.39 | 4 (4.9) | 22 (5.9) | 1.0 |
(Auto)-intoxication |
67 (7.1)
|
1 (0.6)
|
66 (8.5)
| <0.001
|
1 (1.2)
|
64 (15.9)
| <0.001
| 0 | 2 (0.5) | 1.0 |
Renal and/or electrolyte problems | 49 (5.2) | 9 (5.5) | 40 (5.1) | 0.85 | 5 (6.1) | 16 (4.0) | 0.38 | 4 (4.9) | 24 (6.4) | 0.80 |
Allergy/anaphylaxis | 19 (2.0) | 1 (0.6) | 18 (2.3) | 0.23 | 1 (1.2) | 12 (3.0) | 0.71 | 0 | 6 (1.6) | 0.60 |
Syncope | 8 (0.9) | 0 | 8 (1.0) | 0.36 | 0 | 4 (1.0) | 1.0 | 0 | 4 (1.1) | 1.0 |
Cardiac | 8 (0.9) | 1 (0.6) | 7 (0.9) | 1.0 | 0 | 2 (0.5) | 1.0 | 1 (1.2) | 5 (1.3) | 1.0 |
Other | 99 (10.5) | 18 (11.0) | 81 (10.4) | 0.82 | 7 (8.5) | 39 (9.7) | 0.75 | 11 (13.6) | 42 (11.2) | 0.55 |
AE as reason for index admission | 333 (35.4) | 65 (39.9) | 268 (34.5) | 0.19 | 33 (40.2) | 124 (30.8) | 0.10 | 32 (39.5) | 144 (38.5) | 0.87 |
Length of stay, days | 5 (1–131) | 6 (1–66) | 5 (1–131) | 0.20 |
6 (1–66)
|
4 (1–78)
|
0.01
| 6 (1–36) | 7 (1–131) | 0.44 |
Day of discharge, day in weekend | 182 (19.4) | 33 (20.2) | 149 (19.2) | 0.75 | 20 (24.4) | 84 (20.8) | 0.48 | 13 (16.0) | 65 (17.4) | 0.77 |
Season of discharge | ||||||||||
Spring | 251 (26.7) | 42 (25.8) | 209 (26.9) | 0.77 | 17 (20.7) | 107 (26.6) | 0.27 | 25 (30.9) | 102 (27.3) | 0.51 |
Summer | 243 (25.9) | 47 (28.8) | 196 (25.2) | 0.34 | 24 (29.3) | 109 (27.0) | 0.68 | 23 (28.4) | 87 (23.3) | 0.33 |
Autumn |
234 (24.9)
|
29 (17.8)
|
205 (26.4)
|
0.02
| 20 (24.4) | 106 (26.3) | 0.72 |
9 (11.1)
|
99 (26.5)
|
0.002
|
Winter | 212 (22.6) | 45 (27.6) | 167 (21.5) | 0.09 | 21 (25.6) | 81 (20.1) | 0.26 | 24 (29.6) | 86 (23.0) | 0.21 |
Possible factors (reference) | Multivariate analyses in all agesb
| Multivariate analyses in younger patients (<65 years)b
| Multivariate analyses in older patients (≥65 years)b
| |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total study population | AE groupc
| Total study population | AE groupc
| Total study population | AE groupc
| |||||||
N = 940 |
N = 333 |
N = 485 |
N = 157 |
N = 455 |
N = 176 | |||||||
HR (95 % CI) |
p value | HR (95 % CI) |
p value | HR (95 % CI) |
p value | HR (95 % CI) |
p value | HR (95 % CI) |
p value | HR (95 % CI) |
p value | |
Age, in yearsa
| 1.12 (0.78–1.62) | 0.53 | 0.97 (0.54–1.73) | 0.91 |
1.03 (1.01–1.05)
|
0.02
| 1.01 (0.97–1.05) | 0.61 | 0.98 (0.95–1.02) | 0.37 | 1.02 (0.96–1.08) | 0.51 |
Sex (female) | 0.78 (0.55–1.11) | 0.17 | 0.63 (0.35–1.11) | 0.11 | 0.80 (0.49–1.31) | 0.37 | 0.70 (0.31–1.58) | 0.39 | 0.77 (0.46–1.27) | 0.30 | 0.48 (0.20–1.15) | 0.10 |
CCI (0–2) | 1.45 (0.99–2.12) | 0.06 | 1.31 (0.74–2.33) | 0.35 | 1.59 (0.89–2.83) | 0.12 | 1.84 (0.81–4.19) | 0.15 | 1.16 (0.68–1.96) | 0.59 | 0.90 (0.39–2.08) | 0.81 |
Number of medications used (0–5) | ||||||||||||
5–10 | 0.79 (0.53–1.19) | 0.27 | 0.89 (0.47–1.68) | 0.72 | 0.84 (0.45–1.56) | 0.58 | 0.86 (0.35–2.14) | 0.75 | 0.67 (0.39–1.18) | 0.17 | 0.88 (0.35–2.20) | 0.78 |
10–15 | 0.66 (0.34–1.25) | 0.20 | 0.62 (0.25–1.54) | 0.30 | 1.34 (0.50–3.62) | 0.56 | 0.57 (0.13–2.47) | 0.46 |
0.40 (0.17–0.95)
|
0.04
| 0.54 (0.16–1.83) | 0.32 |
>15 | 0.63 (0.20–1.97) | 0.42 | 0.87 (0.22–3.50) | 0.85 | 1.35 (0.29–6.20) | 0.70 | 1.28 (0.19–8.63) | 0.80 | 0.22 (0.03–1.76) | 0.15 | 0.48 (0.05–4.56) | 0.52 |
ADL dependency |
2.43 (1.10–5.35)
|
0.03
|
7.05 (1.61–30.9)
|
0.01
| 1.76 (0.25–12.4) | 0.57 | 1.40 (0.12–16.9) | 0.78 |
3.19 (1.27–8.01)
|
0.01
|
10.0 (1.62–62.3)
|
0.01
|
Cognitive impairment | 0.54 (0.25–1.17) | 0.12 | 0.26 (0.04–1.57) | 0.14 | 0.74 (0.14–3.91) | 0.72 | – | – | 0.45 (0.18–1.12) | 0.09 | 0.24 (0.03–1.84) | 0.17 |
Living situation (home) | 0.67 (0.29–1.56) | 0.36 | 0.24 (0.04–1.40) | 0.11 | 0.41 (0.03–5.45) | 0.50 | – | – | 0.91 (0.36–2.33) | 0.85 | 0.25 (0.04–1.82) | 0.17 |
AE as reason for the index admission | 1.20 (0.83–1.75) | 0.33 | NA | NA | 1.12 (0.65–1.95) | 0.68 | NA | NA | 1.12 (0.66–1.91) | 0.68 | NA | NA |
Length of stay (linear) | 1.01 (0.99–1.02) | 0.45 | 0.99 (0.96–1.03) | 0.67 | 1.02 (0.99–1.04) | 0.21 | 1.0 (0.94–1.06) | 0.93 | 0.99 (0.96–1.02) | 0.53 | 0.99 (0.95–1.03) | 0.65 |
Season of discharge (summer) | ||||||||||||
Spring | 0.83 (0.52–1.33) | 0.44 | 0.71 (0.32–1.55) | 0.39 | 0.74 (0.37–1.48) | 0.39 | 0.65 (0.21–2.03) | 0.46 | 0.93 (0.48–1.81) | 0.84 | 0.92 (0.29–2.91) | 0.89 |
Autumn | 0.60 (0.36–1.01) | 0.05 | 0.50 (0.22–1.14) | 0.10 | 1.03 (0.52–2.02) | 0.94 | 0.62 (0.20–1.95) | 0.41 |
0.33 (0.14–0.77)
|
0.01
| 0.42 (0.12–1.49) | 0.18 |
Winter | 1.10 (0.69–1.76) | 0.69 | 0.84 (0.40–1.77) | 0.66 | 1.12 (0.57–2.19) | 0.75 | 0.86 (0.30–2.46) | 0.78 | 1.01 (0.51–1.98) | 0.98 | 0.82 (0.27–2.51) | 0.83 |
Day of discharge (weekday) | 1.10 (0.71–1.70) | 0.66 | 1.46 (0.77–2.76) | 0.24 | 1.27 (0.71–2.27) | 0.42 | 1.26 (0.52–3.06) | 0.61 | 0.93 (0.47–1.85) | 0.85 | 1.59 (0.62–4.07) | 0.33 |
Younger and older patients
Patients with an index admission because of an AE
Study population | All individuals | Younger individuals (<65 years) | Older individuals (≥65 years) | |||||||
---|---|---|---|---|---|---|---|---|---|---|
N (%) or median (range) | Total study population | Readmission group | No readmission group |
p value* | Readmission group | No readmission group |
p value* | Readmission group | No readmission group |
p value* |
N = 333 |
N = 65 (19.5) |
N = 268 (80.5) |
N = 33 (21.0) |
N = 124 (79.0) |
N = 32 (18.2) |
N = 144 (81.8) | ||||
Type of AE as reason for index admission | ||||||||||
Medication-related |
179 (53.8)
|
27 (41.5)
|
152 (56.7)
|
0.03
|
10 (30.3)
|
61 (49.2)
|
0.05
| 17 (53.1) | 91 (63.2) | 0.29 |
Chemotherapy-related |
74 (22.2)
|
21 (32.3)
|
53 (19.8)
|
0.03
|
15 (45.5)
|
33 (26.6)
|
0.04
| 6 (18.8) | 20 (13.9) | 0.58 |
Procedure-related |
50 (15.0)
|
15 (23.1)
|
34 (13.1)
|
0.04
| 7 (21.2) | 15 (12.1) | 0.18 | 8 (25.0) | 20 (13.9) | 0.18 |
Diabetes mellitus-related | 29 (8.7) | 2 (3.1) | 27 (10.1) | 0.09 | 1 (3.0) | 15 (12.1) | 0.13 | 1 (3.1) | 12 (8.3) | 0.47 |
Other | 1 (0.3) | 0 | 1 (0.4) | 1.0 | 0 | 0 | NA | 0 | 1 (0.7) | 1.0 |