TY - JOUR
T1 - Predicting readmission risk of patients with diabetes hospitalized for cardiovascular disease
T2 - a retrospective cohort study
AU - Rubin, Daniel J.
AU - Golden, Sherita Hill
AU - McDonnell, Marie E.
AU - Zhao, Huaqing
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/8
Y1 - 2017/8
N2 - Objective To develop and validate a tool that predicts 30d readmission risk of patients with diabetes hospitalized for cardiovascular disease (CVD), the Diabetes Early Readmission Risk Indicator-CVD (DERRI-CVD™). Methods A cohort of 8189 discharges was retrospectively selected from electronic records of adult patients with diabetes hospitalized for CVD. Discharges of 60% of the patients (n = 4950) were randomly selected as a training sample and the remaining 40% (n = 3219) were the validation sample. Results Statistically significant predictors of all-cause 30d readmission risk were identified by multivariable logistic regression modeling: education level, employment status, living within 5 miles of the hospital, pre-admission diabetes therapy, macrovascular complications, admission serum creatinine and albumin levels, having a hospital discharge within 90 days pre-admission, and a psychiatric diagnosis. Model discrimination and calibration were good (C-statistic 0.71). Performance in the validation sample was comparable. Predicted 30d readmission risk was similar in the training and validation samples (38.6% and 35.1% in the highest quintiles). Conclusions The DERRI-CVD™ may be a valid tool to predict all-cause 30d readmission risk of patients with diabetes hospitalized for CVD. Identifying high-risk patients may encourage the use of interventions targeting those at greatest risk, potentially leading to better outcomes and lower healthcare costs.
AB - Objective To develop and validate a tool that predicts 30d readmission risk of patients with diabetes hospitalized for cardiovascular disease (CVD), the Diabetes Early Readmission Risk Indicator-CVD (DERRI-CVD™). Methods A cohort of 8189 discharges was retrospectively selected from electronic records of adult patients with diabetes hospitalized for CVD. Discharges of 60% of the patients (n = 4950) were randomly selected as a training sample and the remaining 40% (n = 3219) were the validation sample. Results Statistically significant predictors of all-cause 30d readmission risk were identified by multivariable logistic regression modeling: education level, employment status, living within 5 miles of the hospital, pre-admission diabetes therapy, macrovascular complications, admission serum creatinine and albumin levels, having a hospital discharge within 90 days pre-admission, and a psychiatric diagnosis. Model discrimination and calibration were good (C-statistic 0.71). Performance in the validation sample was comparable. Predicted 30d readmission risk was similar in the training and validation samples (38.6% and 35.1% in the highest quintiles). Conclusions The DERRI-CVD™ may be a valid tool to predict all-cause 30d readmission risk of patients with diabetes hospitalized for CVD. Identifying high-risk patients may encourage the use of interventions targeting those at greatest risk, potentially leading to better outcomes and lower healthcare costs.
KW - Cardiovascular disease
KW - Diabetes
KW - Hospital
KW - Readmission risk
KW - Risk prediction
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U2 - 10.1016/j.jdiacomp.2017.04.021
DO - 10.1016/j.jdiacomp.2017.04.021
M3 - Article
C2 - 28571933
AN - SCOPUS:85019712117
SN - 1056-8727
VL - 31
SP - 1332
EP - 1339
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 8
ER -