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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

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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.
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Metagegevens
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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