Risk Factors for 30-Day Readmission in Adults with Sickle Cell Disease

Area of Science:

• Hematology
• Public Health
• Clinical Medicine

Background:

• Hospital readmission within 30 days is a key quality indicator.
• Few modifiable risk factors for 30-day readmissions in adults with sickle cell disease (SCD) are identified.
• Vasoocclusive pain episodes are a common reason for SCD readmissions.

Purpose of the Study:

• To identify potentially modifiable risk factors for 30-day hospital readmission in adults with SCD.
• To analyze risk factors specifically for readmission due to vasoocclusive pain episodes.
• To inform strategies for reducing readmission rates in SCD patients.

Main Methods:

• Retrospective review of medical records of 88 adult SCD patients over 3.5 years.
• Analysis of 158 first admissions for vasoocclusive pain episodes.
• Multivariable modeling of seven risk factors including PCP listing and prior hospitalization history.

Main Results:

• Absence of a listed primary care provider (PCP) was associated with lower readmission risk (OR 0.38).
• Higher number of prior hospitalizations for vasoocclusive pain episodes significantly increased readmission risk (OR 1.30).
• Median time to readmission was 11 days.

Conclusions:

• Ensuring access to a primary care provider may reduce 30-day readmissions in adults with SCD.
• Improved discharge planning is recommended to decrease readmission rates.
• Targeting patients with frequent prior hospitalizations may be beneficial.