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Outcomes and Predictors of 30-Day Readmissions for Hyperthyroidism: A Nationwide Study
Michael Salim1, Zain El-Amir2, Asim Kichloo2,3
1Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA.
Insights
Hyperthyroidism patients face a 10.3% 30-day readmission rate, increasing mortality and hospital costs. Key predictors include high comorbidity, leaving against medical advice, malnutrition, and atrial fibrillation.
Area of Science:
- Cardiology
- Endocrinology
- Health Services Research
Background:
- Hyperthyroidism is linked to increased cardiovascular risks and poorer hospital outcomes.
- Understanding 30-day readmission patterns in hyperthyroidism is crucial for improving patient care and reducing healthcare burdens.
Purpose of the Study:
- To analyze the characteristics and predictors of 30-day all-cause readmissions in patients diagnosed with hyperthyroidism using the Nationwide Readmissions Database (NRD).
Main Methods:
- Utilized the Nationwide Readmissions Database (NRD) for 2018 to identify patients with hyperthyroidism.
- Analyzed demographic data, comorbidities, and hospital outcomes associated with 30-day readmissions.
Main Results:
- The 30-day all-cause readmission rate for hyperthyroidism was 10.3%.
- Readmissions were significantly associated with increased inpatient mortality (OR, 7.04), longer length of stay, and higher hospital charges.
- Independent predictors for readmission included Charlson Comorbidity Index ≥3, discharge against medical advice, protein-energy malnutrition, and atrial fibrillation.
Conclusions:
- Hyperthyroidism readmissions pose significant risks, including mortality and increased healthcare costs.
- Identifying high-risk patients through factors like comorbidities and discharge status is essential.
- Enhanced patient monitoring and management strategies are recommended to mitigate hyperthyroidism readmissions.
Abstract:
Hyperthyroidism is associated with an elevated risk of cardiovascular events and worse hospital outcomes. The Nationwide Readmissions Database (NRD) 2018 was used to determine the characteristics of 30-day readmission in patients with hyperthyroidism. The 30-day all-cause readmission rate for hyperthyroidism was 10.3%. About 21.7% had hyperthyroidism as the principal diagnosis on readmission. Readmissions were associated with an increased odds of inpatient mortality (odds ratio, 7.04; 95% confidence interval [CI], 3.97 to 12.49), length of stay (5.2 days vs. 4.0 days; 95% CI, 0.7 to 1.8), total hospital charges, and cost of hospitalizations. Independent predictors of 30-day all-cause readmissions included Charlson Comorbidity Index ≥3 (adjusted hazard ratio [aHR], 1.76; 95% CI, 1.15 to 2.71), discharge against medical advice (aHR, 2.30; 95% CI, 1.50 to 3.53), protein-energy malnutrition (aHR, 1.54; 95% CI, 1.15 to 2.07), and atrial fibrillation (aHR, 1.41; 95% CI, 1.11 to 1.79). Aggressive but appropriate monitoring is warranted in patients with hyperthyroidism to prevent readmissions.
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