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Rate and Modifiable Predictors of 30-Day Readmission in Patients with Acute Respiratory Distress Syndrome in the United States
Journal article   Open access   Peer reviewed

Rate and Modifiable Predictors of 30-Day Readmission in Patients with Acute Respiratory Distress Syndrome in the United States

Harshil Shah, Uvesh Mansuri, Sukrut Pagad, Reshmi Adupa, Jagmeet Singh, Khin Tun, Chail Shah, Solomon Tuonuur, Priyal J Shah, Mir Z Ali Khan, …
Curēus (Palo Alto, CA), v 12(6), 8922
30 Jun 2020
PMID: 32760623
url
https://doi.org/10.7759/cureus.8922View
Published, Version of Record (VoR) Open

Abstract

Epidemiology/Public Health Pulmonology Internal Medicine
Background The 30-day readmission rates are being used as a quality measure by Centers for Medicare and Medicaid Services (CMS) for specific medical and surgical conditions. Acute respiratory distress syndrome (ARDS) is one of the important causes of morbidity and mortality in the United States (US). The characteristics and predictors of 30-day readmission in ARDS patients in the US are not widely known, which we have depicted in our study. Objective The aim of this study is to identify 30-day readmission rates, characteristics, and predictors of ARDS patients using the largest publicly available nationwide database. Methods We used the National Readmission Database from the year 2013 to extract the patients with ARDS by primary discharge diagnosis with ICD9-CM codes. All-cause unplanned 30-day readmission rates were calculated for patients admitted between January and November 2013. The independent predictors for unplanned 30-day readmission were identified by survey logistic regression. Results After excluding elective readmission, the all-cause unplanned 30-day readmission rate for ARDS patients was 18%. Index admissions readmitted within 30-day had a significantly higher baseline burden of comorbidities with a Charlson Comorbidity Index (CCI) ≥1 as compared to those who were not readmitted within 30 days. In multivariate regression analysis, several predictors associated with 30-day readmission were self-pay/no charge/other (OR 1.19, 95%CI: 1.02-1.38; p  = 0.02), higher-income class (OR 0.86, 95%CI:0.79-0.99; p  = 0.03), private insurance (OR 0.81, 95%CI:0.67-0.94; p  = 0.01), and teaching metropolitan hospital (OR 0.72, 95%CI:0.61-0.94; p  = 0.01). Conclusion The unplanned 30-day readmission rates are higher in ARDS patients in the US. Several modifiable factors such as insurance, socioeconomic status, and hospital type are associated with 30-day readmission among ARDS patients.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Medicine, General & Internal
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