Predicting readmission risk of patients with diabetes hospitalized for cardiovascular disease: a retrospective cohort study

Daniel J. Rubin, Sherita Hill Golden, Marie E. McDonnell, Huaqing Zhao

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1332-1339
Number of pages8
JournalJournal of Diabetes and its Complications
Volume31
Issue number8
DOIs
StatePublished - Aug 2017

Keywords

  • Cardiovascular disease
  • Diabetes
  • Hospital
  • Readmission risk
  • Risk prediction

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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