Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study
Objective The aim of this study was to describe rates and characteristics of non‐elective 30‐day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission. Design We analysed the 2018 National Readmission Database. Adrenal insufficiency hospitalization...
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| Veröffentlicht in: | Clinical endocrinology (Oxford) 2021-08, Vol.95 (2), p.269-276 |
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| creator | Kichloo, Asim El‐amir, Zain Shaka, Hafeez Wani, Farah Syed, Sofia Junaid |
| description | Objective
The aim of this study was to describe rates and characteristics of non‐elective 30‐day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission.
Design
We analysed the 2018 National Readmission Database. Adrenal insufficiency hospitalizations were identified using the International Classification of Diseases, Tenth Revisions, Clinical Modification diagnosis codes for principal diagnostic codes of primary adrenal insufficiency, Addisonian crisis, drug‐induced adrenocortical insufficiency, and other and unspecified adrenocortical insufficiency.
Patients
During the study period, 7738 index hospitalizations were identified as patients with AI who met the inclusion criteria. Of these, 7691 were discharged alive.
Measurements
We utilized chi‐squared tests to compare baseline characteristics between readmissions and index hospitalizations. Multivariate Cox regression was used to identify independent predictors of readmission.
Results
The 30‐day all‐cause readmission rate for AI was 17.3%. About 1 in 5 readmissions was for AI. Other reasons for readmission included sepsis (10.8%), unspecified pneumonia (3.1%) and acute renal failure unspecified (1.6%). Readmission was associated with significantly higher odds of inpatient mortality. Independent predictors of 30‐day all‐cause readmissions included index hospitalizations with the Charlson Comorbidity Index (CCI) ≥3 (adjusted hazards ratio (aHR): 2.53, 95% CI: 1.85–3.46, p |
| doi_str_mv | 10.1111/cen.14500 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2528179338</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2528179338</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3130-e182c4c14cb062e7994721976d24d7d8429a14aafa34128ab48d810656ade4683</originalsourceid><addsrcrecordid>eNp10M9O3DAQBnALUcGy7YEXQJa4lENY_3fCbbWCthJqOdBzNGtPJKNsstgJKLc-Qp-RJ6m3CxwqdS6-_Pxp5iPklLNLnmfhsLvkSjN2QGZcGl0IYfQhmTHJWMGMUcfkJKUHxpgumT0ix1JWFZdKz0hzF9EHN_Qx0b6hkr38-u1hohHBb0JKoe8SbfpIwUfsoKWhS2PTBBewc9MVXWY5xD5t0Q3hCWkHQ_6SnYcB1pCQpmH000fyoYE24afXd05-3lzfr74Wtz--fFstbwsnuWQF8lI45bhya2YE2qpSVvDKGi-Ut75UogKuABqQiosS1qr0JWdGG_CoTCnn5PM-dxv7xxHTUOcjHLYtdNiPqRZalNxWUu7o-T_0oR9jXn2ntLbWcGmzutgrl49MEZt6G8MG4lRzVu_Kr3P59d_ysz17TRzXG_Tv8q3tDBZ78BxanP6fVK-uv-8j_wBXn431</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2555776137</pqid></control><display><type>article</type><title>Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kichloo, Asim ; El‐amir, Zain ; Shaka, Hafeez ; Wani, Farah ; Syed, Sofia Junaid</creator><creatorcontrib>Kichloo, Asim ; El‐amir, Zain ; Shaka, Hafeez ; Wani, Farah ; Syed, Sofia Junaid</creatorcontrib><description>Objective
The aim of this study was to describe rates and characteristics of non‐elective 30‐day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission.
Design
We analysed the 2018 National Readmission Database. Adrenal insufficiency hospitalizations were identified using the International Classification of Diseases, Tenth Revisions, Clinical Modification diagnosis codes for principal diagnostic codes of primary adrenal insufficiency, Addisonian crisis, drug‐induced adrenocortical insufficiency, and other and unspecified adrenocortical insufficiency.
Patients
During the study period, 7738 index hospitalizations were identified as patients with AI who met the inclusion criteria. Of these, 7691 were discharged alive.
Measurements
We utilized chi‐squared tests to compare baseline characteristics between readmissions and index hospitalizations. Multivariate Cox regression was used to identify independent predictors of readmission.
Results
The 30‐day all‐cause readmission rate for AI was 17.3%. About 1 in 5 readmissions was for AI. Other reasons for readmission included sepsis (10.8%), unspecified pneumonia (3.1%) and acute renal failure unspecified (1.6%). Readmission was associated with significantly higher odds of inpatient mortality. Independent predictors of 30‐day all‐cause readmissions included index hospitalizations with the Charlson Comorbidity Index (CCI) ≥3 (adjusted hazards ratio (aHR): 2.53, 95% CI: 1.85–3.46, p < .001), protein‐energy malnutrition (aHR: 1.28, 95% CI: 1.02–1.60, p = .035) and obesity (aHR: 1.26, 95% CI: 1.02–1.56, p = .035).
Conclusions
The 30‐day all‐cause readmission rate was 17.3%. AI was the most common reason for readmission among other causes. Readmissions were associated with increased mortality. CCIs of 3 or more, protein‐energy malnutrition and obesity were significant predictors of readmission.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/cen.14500</identifier><identifier>PMID: 33991345</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>adrenal insufficiency ; cost of care ; Hospitalization ; index admissions ; length of stay ; Malnutrition ; Mortality ; mortality risk ; Obesity ; Patients ; Protein-energy malnutrition ; readmissions ; Renal failure ; Sepsis</subject><ispartof>Clinical endocrinology (Oxford), 2021-08, Vol.95 (2), p.269-276</ispartof><rights>2021 John Wiley & Sons Ltd</rights><rights>This article is protected by copyright. All rights reserved.</rights><rights>Copyright © 2021 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3130-e182c4c14cb062e7994721976d24d7d8429a14aafa34128ab48d810656ade4683</cites><orcidid>0000-0002-9456-4581 ; 0000-0002-4683-6845 ; 0000-0003-4788-8572 ; 0000-0001-7649-5634</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcen.14500$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcen.14500$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33991345$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kichloo, Asim</creatorcontrib><creatorcontrib>El‐amir, Zain</creatorcontrib><creatorcontrib>Shaka, Hafeez</creatorcontrib><creatorcontrib>Wani, Farah</creatorcontrib><creatorcontrib>Syed, Sofia Junaid</creatorcontrib><title>Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Objective
The aim of this study was to describe rates and characteristics of non‐elective 30‐day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission.
Design
We analysed the 2018 National Readmission Database. Adrenal insufficiency hospitalizations were identified using the International Classification of Diseases, Tenth Revisions, Clinical Modification diagnosis codes for principal diagnostic codes of primary adrenal insufficiency, Addisonian crisis, drug‐induced adrenocortical insufficiency, and other and unspecified adrenocortical insufficiency.
Patients
During the study period, 7738 index hospitalizations were identified as patients with AI who met the inclusion criteria. Of these, 7691 were discharged alive.
Measurements
We utilized chi‐squared tests to compare baseline characteristics between readmissions and index hospitalizations. Multivariate Cox regression was used to identify independent predictors of readmission.
Results
The 30‐day all‐cause readmission rate for AI was 17.3%. About 1 in 5 readmissions was for AI. Other reasons for readmission included sepsis (10.8%), unspecified pneumonia (3.1%) and acute renal failure unspecified (1.6%). Readmission was associated with significantly higher odds of inpatient mortality. Independent predictors of 30‐day all‐cause readmissions included index hospitalizations with the Charlson Comorbidity Index (CCI) ≥3 (adjusted hazards ratio (aHR): 2.53, 95% CI: 1.85–3.46, p < .001), protein‐energy malnutrition (aHR: 1.28, 95% CI: 1.02–1.60, p = .035) and obesity (aHR: 1.26, 95% CI: 1.02–1.56, p = .035).
Conclusions
The 30‐day all‐cause readmission rate was 17.3%. AI was the most common reason for readmission among other causes. Readmissions were associated with increased mortality. CCIs of 3 or more, protein‐energy malnutrition and obesity were significant predictors of readmission.</description><subject>adrenal insufficiency</subject><subject>cost of care</subject><subject>Hospitalization</subject><subject>index admissions</subject><subject>length of stay</subject><subject>Malnutrition</subject><subject>Mortality</subject><subject>mortality risk</subject><subject>Obesity</subject><subject>Patients</subject><subject>Protein-energy malnutrition</subject><subject>readmissions</subject><subject>Renal failure</subject><subject>Sepsis</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10M9O3DAQBnALUcGy7YEXQJa4lENY_3fCbbWCthJqOdBzNGtPJKNsstgJKLc-Qp-RJ6m3CxwqdS6-_Pxp5iPklLNLnmfhsLvkSjN2QGZcGl0IYfQhmTHJWMGMUcfkJKUHxpgumT0ix1JWFZdKz0hzF9EHN_Qx0b6hkr38-u1hohHBb0JKoe8SbfpIwUfsoKWhS2PTBBewc9MVXWY5xD5t0Q3hCWkHQ_6SnYcB1pCQpmH000fyoYE24afXd05-3lzfr74Wtz--fFstbwsnuWQF8lI45bhya2YE2qpSVvDKGi-Ut75UogKuABqQiosS1qr0JWdGG_CoTCnn5PM-dxv7xxHTUOcjHLYtdNiPqRZalNxWUu7o-T_0oR9jXn2ntLbWcGmzutgrl49MEZt6G8MG4lRzVu_Kr3P59d_ysz17TRzXG_Tv8q3tDBZ78BxanP6fVK-uv-8j_wBXn431</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Kichloo, Asim</creator><creator>El‐amir, Zain</creator><creator>Shaka, Hafeez</creator><creator>Wani, Farah</creator><creator>Syed, Sofia Junaid</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9456-4581</orcidid><orcidid>https://orcid.org/0000-0002-4683-6845</orcidid><orcidid>https://orcid.org/0000-0003-4788-8572</orcidid><orcidid>https://orcid.org/0000-0001-7649-5634</orcidid></search><sort><creationdate>202108</creationdate><title>Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study</title><author>Kichloo, Asim ; El‐amir, Zain ; Shaka, Hafeez ; Wani, Farah ; Syed, Sofia Junaid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3130-e182c4c14cb062e7994721976d24d7d8429a14aafa34128ab48d810656ade4683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>adrenal insufficiency</topic><topic>cost of care</topic><topic>Hospitalization</topic><topic>index admissions</topic><topic>length of stay</topic><topic>Malnutrition</topic><topic>Mortality</topic><topic>mortality risk</topic><topic>Obesity</topic><topic>Patients</topic><topic>Protein-energy malnutrition</topic><topic>readmissions</topic><topic>Renal failure</topic><topic>Sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kichloo, Asim</creatorcontrib><creatorcontrib>El‐amir, Zain</creatorcontrib><creatorcontrib>Shaka, Hafeez</creatorcontrib><creatorcontrib>Wani, Farah</creatorcontrib><creatorcontrib>Syed, Sofia Junaid</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kichloo, Asim</au><au>El‐amir, Zain</au><au>Shaka, Hafeez</au><au>Wani, Farah</au><au>Syed, Sofia Junaid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2021-08</date><risdate>2021</risdate><volume>95</volume><issue>2</issue><spage>269</spage><epage>276</epage><pages>269-276</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><abstract>Objective
The aim of this study was to describe rates and characteristics of non‐elective 30‐day readmission among patients hospitalized for adrenal insufficiency and to assess predictors of readmission.
Design
We analysed the 2018 National Readmission Database. Adrenal insufficiency hospitalizations were identified using the International Classification of Diseases, Tenth Revisions, Clinical Modification diagnosis codes for principal diagnostic codes of primary adrenal insufficiency, Addisonian crisis, drug‐induced adrenocortical insufficiency, and other and unspecified adrenocortical insufficiency.
Patients
During the study period, 7738 index hospitalizations were identified as patients with AI who met the inclusion criteria. Of these, 7691 were discharged alive.
Measurements
We utilized chi‐squared tests to compare baseline characteristics between readmissions and index hospitalizations. Multivariate Cox regression was used to identify independent predictors of readmission.
Results
The 30‐day all‐cause readmission rate for AI was 17.3%. About 1 in 5 readmissions was for AI. Other reasons for readmission included sepsis (10.8%), unspecified pneumonia (3.1%) and acute renal failure unspecified (1.6%). Readmission was associated with significantly higher odds of inpatient mortality. Independent predictors of 30‐day all‐cause readmissions included index hospitalizations with the Charlson Comorbidity Index (CCI) ≥3 (adjusted hazards ratio (aHR): 2.53, 95% CI: 1.85–3.46, p < .001), protein‐energy malnutrition (aHR: 1.28, 95% CI: 1.02–1.60, p = .035) and obesity (aHR: 1.26, 95% CI: 1.02–1.56, p = .035).
Conclusions
The 30‐day all‐cause readmission rate was 17.3%. AI was the most common reason for readmission among other causes. Readmissions were associated with increased mortality. CCIs of 3 or more, protein‐energy malnutrition and obesity were significant predictors of readmission.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33991345</pmid><doi>10.1111/cen.14500</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9456-4581</orcidid><orcidid>https://orcid.org/0000-0002-4683-6845</orcidid><orcidid>https://orcid.org/0000-0003-4788-8572</orcidid><orcidid>https://orcid.org/0000-0001-7649-5634</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | adrenal insufficiency cost of care Hospitalization index admissions length of stay Malnutrition Mortality mortality risk Obesity Patients Protein-energy malnutrition readmissions Renal failure Sepsis |
| title | Predictors of 30‐day readmissions for adrenal insufficiency: A retrospective national database study |
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