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Quality of Life Research

Gepubliceerd in:

18-05-2021

Quality of life after hospitalization predicts one-year readmission risk in a large Swiss cohort of medical in-patients

Auteurs: Tristan Struja, Daniel Koch, Sebastian Haubitz, Beat Mueller, Philipp Schuetz, Timo Siepmann

Gepubliceerd in: Quality of Life Research | Uitgave 7/2021

Abstract

Purpose

Estimating the probability of readmission following hospitalization using prediction scores can be complex. Quality of life (QoL) may provide an easy and effective alternative.

Methods

Secondary analysis of the prospective “TRIAGE” cohort. All medical in-patients admitted to a Swiss tertiary care institution (2016–2019) ≥18 years with a length of stay of ≥2 days (23,309 patients) were included. EQ-5D VAS, EQ-5D index, and Barthel index were assessed at a single telephone interview 30-day after admission. Patients lost to follow-up were excluded. Readmission was defined as a non-elective hospital stay at our institution >24 h within 1 year after discharge and assessed using area under the curve (AUC) analysis with adjustment for confounders.

Results

12,842 patients (43% females, median age 68, IQR 55–78) were included. Unadjusted discrimination was modest at 0.59 (95% CI 0.56–0.62) for EQ-5D VAS. Partially adjusted discrimination (for gender) was identical. Additional adjustment for insurance, Charlson comorbidity index, length of stay, and native language increased the AUC to 0.66 (95% CI 0.63–0.69). Results were robust irrespective of time to event (12, 6 or 3 months). A cut-off in the unadjusted model of EQ-5D VAS of 55 could separate cases with a specificity of 80% and a sensitivity of 30%.

Conclusion

QoL at day 30 after admission can predict one-year readmission risk with similar precision as more intricate tools. It might help for identification of high-risk patients and the design of tailored prevention strategies.

vorige artikel Mental component of health-related quality of life is an independent predictor of incident functional disability among community-dwelling older people: a prospective cohort study

volgende artikel Moving beyond family: unequal burden across mental health patients’ social networks

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Zhou, H., Della, P. R., Roberts, P., Goh, L., & Dhaliwal, S. S. (2016). Utility of models to predict 28-day or 30-day unplanned hospital readmissions: An updated systematic review. British Medical Journal Open, 6(6), e011060. https://doi.org/10.1136/bmjopen-2016-011060CrossRef

Schuetz, P., Aujesky, D., Muller, C., & Muller, B. (2015). Biomarker-guided personalised emergency medicine for all – hope for another hype? Swiss Medical Weekly, 145, w14079. https://doi.org/10.4414/smw.2015.14079CrossRefPubMed

Donze, J., Aujesky, D., Williams, D., & Schnipper, J. L. (2013). Potentially avoidable 30-day hospital readmissions in medical patients: Derivation and validation of a prediction model. JAMA Internal Medicine, 173(8), 632–638. https://doi.org/10.1001/jamainternmed.2013.3023CrossRefPubMed

Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. [Research Support, Non-U.S. Gov’t]. Lancet, 380(9836), 37–43. https://doi.org/10.1016/S0140-6736(12)60240-2CrossRef

Mercer, S. W., Guthrie, B., Furler, J., Watt, G. C., & Hart, J. T. (2012). Multimorbidity and the inverse care law in primary care [Editorial]. BMJ, 344, e4152. https://doi.org/10.1136/bmj.e4152CrossRefPubMed

Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K., Wang, Z., Erwin, P. J., Sylvester, T., Boehmer, K., Ting, H. H., Hassan Murad, M., Shippee, N. D., & Montori, V. M. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095–1107. https://doi.org/10.1001/jamainternmed.2014.1608CrossRefPubMedPubMedCentral

Allard, J. P., Keller, H., Teterina, A., Jeejeebhoy, K. N., Laporte, M., Duerksen, D. R., Gramlich, L., Payette, H., Bernier, P., Davidson, B., & Lou, W. (2016). Lower handgrip strength at discharge from acute care hospitals is associated with 30-day readmission: A prospective cohort study. Clinical Nutrition, 35(6), 1535–1542. https://doi.org/10.1016/j.clnu.2016.04.008CrossRefPubMed

Andreasen, J., Aadahl, M., Sorensen, E. E., Eriksen, H. H., Lund, H., & Overvad, K. (2018). Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study. Archives of Gerontology and Geriatrics, 76, 65–72. https://doi.org/10.1016/j.archger.2018.01.013CrossRefPubMed

Hertzberg, D., Luksha, Y., Kus, I., Eslampia, P., Pickering, J. W., & Holzmann, M. J. (2020). Gait speed at discharge and risk for readmission or death: A prospective study of an emergency ward population. Open Access Emerg Med, 12, 127–135. https://doi.org/10.2147/OAEM.S229479CrossRefPubMedPubMedCentral

10.

van Hout, B., Janssen, M. F., Fen, Y. S., Kohlmann, T., Busschbach, J., Golicki, D., Lloyd, A., Scalone, L., Kind, P., Simon, A., & Pickard. . (2012). Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health, 15(5), 708–715. https://doi.org/10.1016/j.jval.2012.02.008CrossRefPubMed

11.

Wade, D. T., & Collin, C. (1988). The Barthel ADL Index: A standard measure of physical disability? International Disability Studies, 10(2), 64–67. https://doi.org/10.3109/09638288809164105CrossRefPubMed

12.

Schuetz, P., Hausfater, P., Amin, D., Haubitz, S., Fassler, L., Grolimund, E., Kutz, A., Schild, U., Caldara, Z., Regez, K., Zhydkov, A., Kahles, T., Nedeltchev, K., von Felten, S., De Geest, S., Conca, A., Schäfer-Keller, P., Huber, A., Bargetzi, M., … Mueller, B. (2013). Optimizing triage and hospitalization in adult general medical emergency patients: The triage project [Multicenter Study Observational Study Research Support, Non-U.S. Gov’t]. BMC Emergency Medicine, 13, 12. https://doi.org/10.1186/1471-227X-13-12CrossRefPubMedPubMedCentral

13.

Andreasen, J., Gobbens, R. J. J., Eriksen, H. H., & Overvad, K. (2019). Health-related quality of life at hospital discharge as a predictor for 6-month unplanned readmission and all-cause mortality of acutely admitted older medical patients. Quality of Life Research, 28(11), 3015–3024. https://doi.org/10.1007/s11136-019-02259-wCrossRefPubMed

14.

Moons, K. G., Altman, D. G., Reitsma, J. B., Ioannidis, J. P., Macaskill, P., Steyerberg, E. W., Vickers, A. J., Ransohoff, D. F., & Collins, G. S. (2015). Transparent reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration. Annals of Internal Medicine, 162(1), W1-73. https://doi.org/10.7326/M14-0698CrossRefPubMed

15.

Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8CrossRefPubMed

16.

McPhail, S., Beller, E., & Haines, T. (2008). Two perspectives of proxy reporting of health-related quality of life using the Euroqol-5D, an investigation of agreement. Medical Care, 46(11), 1140–1148. https://doi.org/10.1097/MLR.0b013e31817d69a6CrossRefPubMed

17.

R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/

18.

Struja, T., Baechli, C., Koch, D., Haubitz, S., Eckart, A., Kutz, A., Kaeslinutz, M., Mueller, B., & Schuetz, P. (2020). What are they worth? Six 30-day readmission risk scores for medical inpatients externally validated in a Swiss cohort. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-020-05638-zCrossRefPubMed

19.

Uhlmann, M., Lecureux, E., Griesser, A. C., Duong, H. D., & Lamy, O. (2017). Prediction of potentially avoidable readmission risk in a division of general internal medicine. Swiss Medical Weekly, 147, w14470. https://doi.org/10.4414/smw.2017.14470CrossRefPubMed

20.

Tsui, E., Au, S. Y., Wong, C. P., Cheung, A., & Lam, P. (2015). Development of an automated model to predict the risk of elderly emergency medical admissions within a month following an index hospital visit: A Hong Kong experience. Health Informatics Journal, 21(1), 46–56. https://doi.org/10.1177/1460458213501095CrossRefPubMed

21.

Rajkomar, A., Dean, J., & Kohane, I. (2019). Machine learning in medicine. New England Journal of Medicine, 380(14), 1347–1358. https://doi.org/10.1056/NEJMra1814259CrossRef

22.

Karampampa, K., Frumento, P., Ahlbom, A., & Modig, K. (2016). Does a hospital admission in old age denote the beginning of life with a compromised health-related quality of life? A longitudinal study of men and women aged 65 years and above participating in the Stockholm Public Health Cohort. British Medical Journal Open, 6(7), e010901. https://doi.org/10.1136/bmjopen-2015-010901CrossRef

23.

Hutchinson, A., Rasekaba, T. M., Graco, M., Berlowitz, D. J., Hawthorne, G., & Lim, W. K. (2013). Relationship between health-related quality of life, and acute care re-admissions and survival in older adults with chronic illness. Health and Quality of Life Outcomes, 11, 136. https://doi.org/10.1186/1477-7525-11-136CrossRefPubMedPubMedCentral

24.

Belayachi, J., El Khattate, A., Bizrane, M., Madani, N., & Abouqal, R. (2018). Pre-admission quality of life as predictor of outcome after acute care: The role of emotional well-being. QJM, 111(2), 111–115. https://doi.org/10.1093/qjmed/hcx209CrossRefPubMed

25.

Dhaussy, G., Drame, M., Jolly, D., Mahmoudi, R., Barbe, C., Kanagaratnam, L., Nazeyrollas, P., Blanchard, F., Novella, J. L., & SAFES Group. (2012). Is health-related quality of life an independent prognostic factor for 12-month mortality and nursing home placement among elderly patients hospitalized via the emergency department? Journal of the American Medical Directors Association, 13(5), 453–458. https://doi.org/10.1016/j.jamda.2011.10.002CrossRefPubMed

26.

Pearson, S., Stewart, S., & Rubenach, S. (1999). Is health-related quality of life among older, chronically ill patients associated with unplanned readmission to hospital? Australian and New Zealand Journal of Medicine, 29(5), 701–706. https://doi.org/10.1111/j.1445-5994.1999.tb01618.xCrossRefPubMed

27.

Parlevliet, J. L., MacNeil-Vroomen, J., Buurman, B. M., de Rooij, S. E., & Bosmans, J. E. (2016). Health-related quality of life at admission is associated with postdischarge mortality, functional decline, and institutionalization in acutely hospitalized older medical patients. Journal of the American Geriatrics Society, 64(4), 761–768. https://doi.org/10.1111/jgs.14050CrossRefPubMed

28.

Kirby, S. E., Dennis, S. M., Jayasinghe, U. W., & Harris, M. F. (2010). Patient related factors in frequent readmissions: The influence of condition, access to services and patient choice. BMC Health Services Research, 10, 216. https://doi.org/10.1186/1472-6963-10-216CrossRefPubMedPubMedCentral

Titel: Quality of life after hospitalization predicts one-year readmission risk in a large Swiss cohort of medical in-patients
Auteurs: Tristan Struja
Daniel Koch
Sebastian Haubitz
Beat Mueller
Philipp Schuetz
Timo Siepmann
Publicatiedatum: 18-05-2021
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 7/2021
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-02867-5

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