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Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19
1From the, Division of Cardiology, Department of Medicine, New York-Presbyterian Queens, Flushing, NY, USA.
Insights
Early readmission after coronavirus disease 2019 (COVID-19) hospitalization is common, with 4.5% of patients readmitted within 30 days. Most readmissions were due to COVID-19 complications, and a significant mortality rate was observed during readmission.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Limited data exist on the characteristics of 30-day readmissions following hospitalization for coronavirus disease 2019 (COVID-19).
- Understanding readmission patterns is crucial for improving post-discharge care for COVID-19 survivors.
Purpose of the Study:
- To investigate the rate, timing, causes, predictors, and outcomes of 30-day readmissions after COVID-19 hospitalization.
- To identify factors associated with increased risk of readmission in COVID-19 patients.
Main Methods:
- Retrospective observational study including 1062 patients hospitalized with COVID-19 and discharged alive.
- Multivariable logistic regression and restricted cubic spline functions were used to analyze predictors of 30-day readmission.
Main Results:
- A total of 4.5% of patients were readmitted within 30 days, with a median time to readmission of 5 days.
- Hypoxic respiratory failure was the most common reason for readmission (68.8%), followed by thromboembolism (12.5%) and sepsis (6.3%).
- Elevated peak serum creatinine (≥1.29 mg/dL) during initial hospitalization was a significant predictor of 30-day readmission (aOR: 2.41).
Conclusions:
- COVID-19 survivors experience a notable rate of early readmission, primarily due to COVID-19-related morbidities.
- The mortality rate among readmitted COVID-19 patients was substantial (22.9%), highlighting the severity of post-discharge complications.
Background:
There are limited data on the characteristics of 30-day readmission after hospitalization with coronavirus disease 2019 (COVID-19).
Objectives:
To examine the rate, timing, causes, predictors and outcomes of 30-day readmission after COVID-19 hospitalization.
Methods:
From 13 March to 9 April 2020, all patients hospitalized with COVID-19 and discharged alive were included in this retrospective observational study. Multivariable logistic regression was used to identify the predictors of 30-day readmission, and a restricted cubic spline function was utilized to assess the linearity of the association between continuous predictors and 30-day readmission.
Results:
A total of 1062 patients were included in the analysis, with a median follow-up time of 62 days. The mean age of patients was 56.5 years, and 40.5% were women. At the end of the study, a total of 48 (4.5%) patients were readmitted within 30 days of discharge, and a median time to readmission was 5 days. The most common primary diagnosis of 30-day readmission was a hypoxic respiratory failure (68.8%) followed by thromboembolism (12.5%) and sepsis (6.3%). The patients with a peak serum creatinine level of ≥1.29 mg/dL during the index hospitalization, compared to those with a creatinine of <1.29 mg/dL, had 2.4 times increased risk of 30-day readmission (adjusted odds ratio: 2.41; 95% CI: 1.23-4.74). The mortality rate during the readmission was 22.9%.
Conclusion:
With 4.5% of the thirty-day readmission rate, COVID-19 survivors were readmitted early after hospital discharge, mainly due to morbidities of COVID-19. One in five readmitted COVID-19 survivors died during their readmission.
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