Thirty-Day Readmission Rate Is High for Hospitalized Patients Discharged With Home Parenteral Nutrition or...

Area of Science:

• Clinical Nutrition
• Gastroenterology
• Patient Outcomes

Background:

• Reducing hospital readmissions is crucial for healthcare cost containment and quality improvement.
• Limited research exists on 30-day readmission rates and risk factors for patients on home parenteral support (HPS).

Purpose of the Study:

• To determine the 30-day readmission rate for patients discharged with HPS.
• To identify demographic and clinical risk factors, including malnutrition, associated with these readmissions.

Main Methods:

• Retrospective review of 224 patients discharged with HPS from Cleveland Clinic (July 2013-June 2014).
• Analysis of readmission rates and correlation with patient factors using univariable and multivariable models.

Main Results:

• 31.6% of patients experienced unplanned 30-day readmissions.
• Most readmissions (21.1%) were not HPS-related; common causes included infections and dehydration.
• Malnutrition was prevalent (84.4%) but not a significant risk factor for readmission (P=.41).
• Factors associated with lower readmission risk included ostomy, small bowel resection, higher HPS volume, and shorter HPS consult-to-discharge interval.
• History of heart disease and elevated white blood cell count increased readmission risk.

Conclusions:

• Patients on HPS have a high 30-day readmission rate, but the support itself is rarely the direct cause.
• Malnutrition status does not appear to be a significant predictor of 30-day readmissions in this population.