Journal article
Thirty-day hospital readmissions among mechanically ventilated emergency department patients
Emergency medicine journal : EMJ, Vol.35(4), pp.252-256
04/2018
DOI: 10.1136/emermed-2017-206651
PMID: 29305381
Abstract
BackgroundUnplanned 30-day readmissions have a negative impact on patients and healthcare systems. Mechanically ventilated ED patients are at high risk for complications, but factors associated with readmission are unknown.Objective(1) Determine the rate of 30-day hospital readmission for ED patients receiving mechanical ventilation. (2) Identify associations between ED-based risk factors and readmission.DesignRetrospective cohort study.SettingTertiary-care, academic medical centre.PatientsAdult ED patients receiving mechanical ventilation.MeasurementsBaseline demographics, comorbid conditions, illness severity and treatment variables were collected, as were clinical outcomes occurring during the index hospitalisation. The primary outcome was 30-day hospital readmission rate. Multivariable logistic regression was used to evaluate factors associated with the primary outcome.ResultsA total of 1262 patients were studied. The primary outcome occurred in 287 (22.7%) patients. There was no association between care in the ED and readmission. During the index hospitalisation, readmitted patients had shorter ventilator, hospital and intensive care unit duration (P<0.05 for all). The primary outcome was associated with African-American race (adjusted OR 1.34 (95% CI 1.02 to 1.78)), chronic obstructive pulmonary disease (adjusted OR 1.52 (95% CI 1.12 to 2.06)), diabetes mellitus (adjusted OR 1.34 (95% CI 1.02 to 1.78)) and higher illness severity (adjusted OR 1.03 (95% CI 1.01 to 1.05)).ConclusionsAlmost one in four mechanically ventilated ED patients are readmitted within 30 days, and readmission is associated with patient-level and institutional-level factors. Strategies must be developed to identify, treat and coordinate care for the most at-risk patients.
Details
- Title: Subtitle
- Thirty-day hospital readmissions among mechanically ventilated emergency department patients
- Creators
- David B Page - Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Missouri, USAAnne M Drewry - Department of Anesthesiology, Division of Critical Care Medicine, Washington University School of Medicine, St Louis, Missouri, USAEnyo Ablordeppey - Departments of Emergency Medicine and Anesthesiology, Division of Critical Care, Washington University School of Medicine, St Louis, Missouri, USANicholas M Mohr - Departments of Emergency Medicine and Anesthesiology, Division of Critical Care, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa, USAMarin H Kollef - Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Missouri, USABrian M Fuller - Departments of Emergency Medicine and Anesthesiology, Division of Critical Care, Washington University School of Medicine, St Louis, Missouri, USA
- Resource Type
- Journal article
- Publication Details
- Emergency medicine journal : EMJ, Vol.35(4), pp.252-256
- DOI
- 10.1136/emermed-2017-206651
- PMID
- 29305381
- NLM abbreviation
- Emerg Med J
- ISSN
- 1472-0205
- eISSN
- 1472-0213
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984024528402771
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