Predictors of 30-day Unplanned Hospital Readmissions among Maintenance Dialysis Patients

Patients on dialysis are twice as likely to have early readmissions. This study aimed to identify risk factors for 30-day unplanned readmission among patients on maintenance dialysis in a tertiary hospital.

We conducted a retrospective, unmatched, case-control study. Data were taken from patients on maintenance hemodialysis admitted in the University of the Philippines-Philippine General Hospital (UP-PGH) between January 2018 and December 2020. Patients with 30-day readmission were included as cases and patients with >30-day readmissions were taken as controls. Multivariable regression with 30-day readmission as the outcome was used to identify significant predictors of early readmission.

The prevalence of 30-day unplanned readmission among patients on dialysis is 36.96%, 95%CI [31.67, 42.48]. In total, 119 cases and 203 controls were analyzed. Two factors were significantly associated with early readmission: the presence of chronic glomerulonephritis [OR 2.35, 95% CI 1.36 to 4.07, p-value=0.002] and number of comorbidities [OR 1.34, 95% CI 1.12 to 1.61, p-value=0.002]. The most common reasons for early readmission are infection, anemia, and uremia/underdialysis.

Patients with chronic glomerulonephritis and multiple comorbidities have significantly increased odds of early readmission. Careful discharge planning and close follow up of these patients may reduce early readmissions.