Older age, female sex linked to reduced odds for 30-day readmission in ILD

Key takeaways:

• Four factors emerged during logistic regression analysis as being linked to 30-day readmission.
• As loss of function grew in severity, the likelihood for being readmitted within 30 days rose.

BOSTON — The odds for 30-day readmission among patients with interstitial lung disease went down if the patient was 65 years or older or a woman, according to data presented at the CHEST Annual Meeting.

“Our study highlights the significance of identifying risk factors associated with early readmissions in ILD,” Harendra Singh, MBBS, internal medicine resident at BronxCare Health System, New York, and colleagues wrote.

Using the Nationwide Readmission Database, Singh and colleagues assessed patients readmitted to a hospital with ILD within 30 days (3,690 cases; mean age, 67.34 years; Charlson Comorbidity Index, 2.667) or after 30 days (5,565 cases; mean age, 67.83 years; Charlson Comorbidity Index, 2.55) during 2020 to determine what factors make this patient population more and less likely to experience 30-day readmission.

Researchers found a significantly higher proportion of patients with chronic pulmonary disease in the 30-day vs. after 30 days readmission group (49.35% vs. 47.1%; P = .032). Patients readmitted within 30 days also had significantly more patients with complicated hypertension (35.93% vs. 33.06%: P = .004), peripheral vascular disease (10.51% vs. 9.06%; P = .02) and drug abuse (4.28% vs. 3.23%; P = .009), according to the abstract.

Additionally, patients with a quicker readmission spent 6.79 days in the hospital, whereas patients with later readmission spent 6.16 days in the hospital (P = .002).

Prior to multivariate Cox regression analysis, researchers reported a significant link between higher 30-day readmission and the risk for mortality subclass (P < .001), as well as between higher 30-day readmission and the severity of illness subclass (P < .001).

Two characteristics emerged during logistic regression analysis as being linked to reduced odds for readmission within 30 days: age of 65 years and older (OR = 0.78; P = .03) and female sex (OR = 0.87; P = .002).

In contrast, researchers observed a significant link between discharge disposition to a skilled nursing facility or intermediate care facility and heightened odds for 30-day readmission (OR = 1.29; P < .001).

Further, as loss of function grew in severity, the likelihood for being readmitted within 30 days rose. According to the abstract, the odds ratio for 30-day readmission was 1.27 (P = .024) with moderate loss of function, 1.4 (P = .004) with major loss of function and 1.52 (P = .001) with extreme loss of function.

“[This study] emphasizes the need of bigger studies in this milieu to reduce the health care costs associated with ILD, to decrease the length of stay and to target overall control of risk factors to alleviate the mortality and morbidity burden associated with ILD,” Singh and colleagues wrote.