You are here

  • Home
  • Archive
  • Volume 11, Issue 7
  • Risk of 30-day hospital readmission associated with medical conditions and drug regimens of polymedicated, older inpatients discharged home: a registry-based cohort study

Article Text

Article menu
XML
Geriatric medicine
Original research
Risk of 30-day hospital readmission associated with medical conditions and drug regimens of polymedicated, older inpatients discharged home: a registry-based cohort study
  1. Filipa Pereira1,2,
  2. Henk Verloo2,3,
  3. Zhivko Taushanov4,
  4. Saviana Di Giovanni2,5,
  5. Carla Meyer-Massetti6,
  6. Armin von Gunten3,
  7. Maria Manuela Martins1,7,
  8. Boris Wernli8
  1. 1Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
  2. 2School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland
  3. 3Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
  4. 4Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
  5. 5Pharmacy Benu Tavil-Chatton, Morges, Switzerland
  6. 6Institute for Primary Health Care, University of Bern, Bern, Switzerland
  7. 7Porto Higher School of Nursing, Porto, Portugal
  8. 8FORS, Swiss Centre of Expertise in the Social Sciences, University of Lausanne, Lausanne, Switzerland
  1. Correspondence to Filipa Pereira; filipa.pereira{at}hevs.ch

Abstract

Objectives The present study analysed 4 years of a hospital register (2015–2018) to determine the risk of 30-day hospital readmission associated with the medical conditions and drug regimens of polymedicated, older inpatients discharged home.

Design Registry-based cohort study.

Setting Valais Hospital—a public general hospital centre in the French-speaking part of Switzerland.

Participants We explored the electronic records of 20 422 inpatient stays by polymedicated, home-dwelling older adults held in the hospital’s patient register. We identified 13 802 hospital stays by older adults who returned home involving 8878 separate patients over 64 years old.

Outcome measures Sociodemographic characteristics, medical conditions and drug regimen data associated with risk of readmission within 30 days of discharge.

Results The overall 30-day hospital readmission rate was 7.8%. Adjusted multivariate analyses revealed increased risk of hospital readmission for patients with longer hospital length of stay (OR=1.014 per additional day; 95% CI 1.006 to 1.021), impaired mobility (OR=1.218; 95% CI 1.039 to 1.427), multimorbidity (OR=1.419 per additional International Classification of Diseases, 10th Revision condition; 95% CI 1.282 to 1.572), tumorous disease (OR=2.538; 95% CI 2.089 to 3.082), polypharmacy (OR=1.043 per additional drug prescribed; 95% CI 1.028 to 1.058), and certain specific drugs, including antiemetics and antinauseants (OR=3.216 per additional drug unit taken; 95% CI 1.842 to 5.617), antihypertensives (OR=1.771; 95% CI 1.287 to 2.438), drugs for functional gastrointestinal disorders (OR=1.424; 95% CI 1.166 to 1.739), systemic hormonal preparations (OR=1.207; 95% CI 1.052 to 1.385) and vitamins (OR=1.201; 95% CI 1.049 to 1.374), as well as concurrent use of beta-blocking agents and drugs for acid-related disorders (OR=1.367; 95% CI 1.046 to 1.788).

Conclusions Thirty-day hospital readmission risk was associated with longer hospital length of stay, health disorders, polypharmacy and drug regimens. The drug regimen patterns increasing the risk of hospital readmission were very heterogeneous. Further research is needed to explore hospital readmissions caused solely by specific drugs and drug–drug interactions.

  • geriatric medicine
  • clinical pharmacology
  • epidemiology

Data availability statement

Data are available upon reasonable request.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2021-052755

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Footnotes

    • Twitter @mmmartins1956

    • Contributors BW, FP and HV had the original idea. BW, ZT, SDG, MMM and HV provided conceptual and methodological expertise to the study design and BW, FP, ZT, SDG, CM-M, AV-G and HV to data analysis and interpretation. BW, FP and HV were major contributors to writing the manuscript. All authors read, edited and approved the final manuscript.

    • Funding This study was supported by the Swiss National Science Foundation via grant number 407440_183434/1. This research was developed, in part, using grants from the Swiss National Science Foundation and the School of Health Sciences of the University of Applied Sciences and Arts Western Switzerland (HES-SO) Valais/Wallis.

    • Disclaimer The funders had no role in the design and conduct of the study, collection, management, analysis and interpretation of data, preparation, review or approval of the manuscript, or the decision to submit the manuscript for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.