Clinical and nutritional predictors of hospital readmission within 30 days

Abstract

Background/objectives Identify clinical, sociodemographic, and nutritional predictors of hospital readmission within 30 days. Subjects/methods A longitudinal study was conducted with patients hospitalised at a public institution in Recife, Brazil. Sociodemographic (age, sex, race, and place of residence), clinical (diagnosis, comorbidities, medications, polypharmacy, hospital outcome, hospital stay, and occurrence of readmission within 30 days), and nutritional (% of weight loss, body mass index, arm circumference [AC], and calf circumference [CC]) characteristics were collected from the nutritional assessment files and patient charts. Nutritional risk was determined using the 2002 Nutritional Risk Screening tool and the diagnosis of malnutrition was based on the GLIM criteria. Results The sample was composed of 252 patients, 58 (23.0%; CI_95%: 17.2–28.8%) of whom were readmitted within 30 days after discharge from hospital, 135 (53.5%; CI_95%: 46.7–60.5%) were at nutritional risk and 107 (42.4%; CI_95%: 35.6–49.3%) were malnourished. In the bivariate analysis, polypharmacy, nutritional risk, malnutrition, low AC, and low CC were associated with readmission. In the multivariate analysis, low CC was considered an independent risk factor, increasing the likelihood of hospital readmission nearly fourfold. In contrast, the absence of polypharmacy was a protective favour, reducing the likelihood of readmission by 81%. Conclusions The use of six medications or more and low calf circumference are risk factors for hospital readmission within 30 days after discharge.