Assessment of Readmission Risk Factors After Index Hospital Discharge for COVID-19 Patients

Saturday, January 21, 2023

5:30 PM – 5:45 PM PT

Location: 304

First Author(s)

VB

Vikas Bansal, MPH, MBBS

Research Fellow
Mayo Clinic
Rochester, Minnesota

Disclosure information not submitted.

Co-Author(s)

AT

Aysun Tekin, MD

Mayo Clinic
Rochester, Minnesota

Disclosure information not submitted.
RS

Romil Singh, MD

Resident
n/a
Rochester, Minnesota, United States

Disclosure information not submitted.
NS

Nikhil Sharma, MD

Research Fellow
n/a, United States

Disclosure information not submitted.
Juan Pablo Domecq Garces, MD

Assistant Professor of Medicine
Mayo Clinic College of Medicine
North Mankato, Minnesota, United States

Disclosure information not submitted.
RC

Rodrigo Cartin-Ceba, MD, MS

Professor of Medicine, Pulmonary and Critical Care
Mayo Clinic, United States

Disclosure information not submitted.
SK

Syed Anjum Khan, MD

Assistant Professor of Medicine
Mayo Clinic College of Medicine, United States

Disclosure information not submitted.
Devang Sanghavi, MD, MHA

Mayo Clinic Hospital Jacksonville
Jacksonville, Florida

Disclosure information not submitted.
AL

Abigail T. La Nou, MD

Medical Doctor
Mayo Clinic Health System in Eau Claire, United States

Disclosure information not submitted.
NJ

Nitesh K. Jain, MD, MBBS

Mayo Clinic Health System in Mankato
Mankato

Disclosure information not submitted.
RM

Roman Melamed, MD

Consultant
Abbott Northwestern Hospital, United States

Disclosure information not submitted.
Ashish K. Khanna, MD, MS

Anesthesiologist & Intensivist, Associate Professor of Anesthesiology
Wake Forest Baptist Medical Center
Winston Salem, North Carolina

Disclosure information not submitted.
AC

Amy B. Christie, MD

Surgical Critical Care Physician
Atrium Health Navicent, United States

Disclosure information not submitted.
VB

Valerie M. Banner-Goodspeed, MPH

Clinical Research Administrator
Beth Israel Deaconess Medical Center, United States

Disclosure information not submitted.
DA

Donna Armaignac, CCNS, CCRN-K, PhD

Director Center Advanced Analytics; Director Best Practice Tele Critical Care
Baptist Health South Florida
Pompano Beach, Florida

Disclosure information not submitted.
UR

Umamaheswara Raju, MD

Dr.
Gandhi Medical College and Hospital, Hyderabad, United States

Disclosure information not submitted.
MA

Murtaza Akhter, MD

Consultant
Valleywise Health Medical Center, United States

Disclosure information not submitted.
YT

Yasir Tarabichi, MSCR

Consultant
Metro Health Medical Center, United States

Disclosure information not submitted.
VK

Vishakha K. Kumar, MD, MBA

Society of Critical Care Medicine
Mount Prospect, Illinois

Disclosure information not submitted.
Rahul Kashyap, MD, MBA,

Medical Director Research
Wellspan Health-York Hospital
York, Pennsylvania

Disclosure information not submitted.

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.