Abstract
Hospital readmissions are a major problem in the older people as they are frequent, costly, and life-threatening. Falls among older adults are the leading cause of injury, deaths, and emergency department visits for trauma. The main objective was to determine risk factors associated with a 30-day readmission after index hospital admission for fall-related injuries. A retrospective nested case-control study was conducted. Data from elderly patients initially hospitalized for fall-related injuries in 2019, in 11 of the Greater Paris University Hospitals and discharged home, were retrieved from the clinical data warehouse. Cases were admission of elderly patients who subsequently experienced a readmission within 30 days after discharge from the index admission. Controls were admission of elderly patients who were not readmitted to hospital. Among 670 eligible index admissions, 127 (18.9%) were followed by readmission within 30 days after discharge. After multivariate analysis, men sex (odds ratio [OR] = 2.29, 95% confidence interval [CI] = 1.45-3.61), abnormal concentration of C-reactive protein, and anemia (OR = 2.22, 95% CI = 1.28-3.85; OR = 1.85, 95% CI = 1.11-3.11, respectively) were associated with a higher risk of readmission. Oppositely, having a traumatic injury at index admission decreased this risk (OR = 0.47, 95% CI = 0.28-0.81). Reducing early unplanned readmission is crucial, especially in elderly patients susceptible to falls. Our results indicate that the probability of unplanned readmission is higher for patients with specific characteristics that should be taken into consideration in interventions designed to reduce this burden.
Highlights
Hospital readmissions are defined as patient admissions within a specified time frame following discharge from index hospital admission
Our study showed that male gender, abnormal concentration of C-reactive protein (CRP) and anaemia at index admission were independently associated with increased risk of 30-day hospital readmission
Several studies found that male gender was significantly associated with a higher risk of hospital readmission [15,32], previous studies conducted in the United States (US) have shown that in a population of patients initially hospitalized for a hip fracture which is a diagnosis often associated with a fall, men were more likely to be readmitted within 30 days after discharge than women [33,34]
Summary
Hospital readmissions are defined as patient admissions within a specified time frame following discharge from index hospital admission. Hospital readmission rate within 30 days of discharge from an index admission serves as a key indicator for measuring the quality of patient health care and is adopted by major healthcare stakeholders nationally and internationally [1]. Older adults have a greater risk of being admitted to hospital than any other age group and FRIs account for many of these hospital admissions. Hospitalization of elderly patients, especially those admitted for FRIs is associated with an increased risk of functional worsening, loss of independence, overall deterioration and a high rate of hospital readmission [20,21]. The main objective of our study was to identify risk factors associated with unplanned hospital readmission within 30 days after discharge.
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