7: ASSESSMENT OF READMISSION RISK FACTORS AFTER INDEX HOSPITAL DISCHARGE FOR COVID-19 PATIENTS

Abstract

Introduction: During the COVID-19 pandemic, the burden on the healthcare system makes it critical to examine readmission patterns. In this study, we evaluated the readmission rates and risk factors associated with COVID-19 from the large SCCM Discovery VIRUS: COVID-19 Registry. Methods: This was a retrospective, cohort study including hospitalized adult patients from 181 hospitals in 24 countries within the VIRUS: COVID-19 Registry. Demographic, clinical, and outcome data were extracted and divided into two groups: Patients with readmission with COVID-19 in 30 days from discharge and those who were not. A univariate analysis is done using chi-square and t-test as appropriate. Multivariable logistic regression was used to measure risk factor associations with 30-day readmission. Results: Among 20,283 patients, 1,195 (5.9%) were readmitted within 30 days from discharge. The median (IQR) age of readmitted patients was 66 (55-78) years and 45.2% were female, 60.2% were white, and 78.9% non-Hispanic. Higher odds of readmission were observed in patients aged >60 vs 18–40 years (OR 2.76; 95% CI, 2.23–3.41), moderate COVID-19 disease (WHO Ordinal scale 4-5) vs Severe COVID-19 (WHO Ordinal scale 6-9) (OR 1.23; 95% CI, 1.10–1.39), no ICU admission at index hospitalization (OR 1.70; 95% CI, 1.32–1.80), and Hospital length of stay ≤14 vs >14 days (OR 1.53; 95% CI, 1.32–1.80) vs those not readmitted (p= < 0.001). Comorbidities including coronary artery disease (OR 2.14; 95% CI 1.84–2.48), hypertension (OR 1.58; 95% CI 1.40–1.78), congestive Heart Failure (OR 2.54; 95% CI 2.16–2.98), chronic pulmonary disease (OR 2.26; 95% CI 1.94–2.63), diabetes (OR 1.32; 95% CI 1.17–1.49) or chronic kidney disease (CKD) (OR 2.41; 95% CI 1.2.09–2.78) were associated with higher odds of readmission. In multivariate logistic regression adjusted for age group, hospital length of stay ≤14 days and, highest WHO COVID-19 ordinal scale and index ICU admission coronary artery disease, congestive heart failure, chronic pulmonary disease, chronic kidney disease, hospital length of stay ≤14 days and age >60 years remained independent risk factors for readmission within 30 days. Conclusions: Among hospitalized patients with COVID-19, those readmitted had a higher burden of comorbidities compared to those non-readmitted.