Predictive Score Categorizes Potentially Avoidable Readmission Risk

By identifying factors significantly associated with potentially avoidable readmissions (PAR), Anne-Laure Blanc, PharmD, Pharmacie des Hôpitaux de l’Est Lémanique in Switzerland, and fellow researchers, created and internally validated a predictive score to signal patients at increased risk of hospital readmission within 30 days. They published their findings online in PLoS One. 

“The PAR-Risk Score may help to identify high-risk patients before discharge home, and this should help health care providers to target complex transitional interventions that improve the coordination of care,” researchers wrote, “with the overarching goal of decreasing readmission rates.” 

To create a risk score, researchers analyzed demographic data, diagnoses, lab results, and medication data for 7317 general internal medicine stays between 2011 and 2013. Of the stays, 562 were followed by a potentially avoidable hospital readmission.  

The following factors were significantly associated with PAR:  

• hospital admission in previous 6 months (the study identified an adjusted odds ratio of 2.3),
• diabetes with organ damage (OR,2.2),
• metastatic carcinoma (OR,1.9),
• chronic ischemic heart disease (OR, 1.7),
• hyperkalemia (OR, 1.4),
• cancer (OR, 1.4),
• hospital stay longer than 4 days (OR, 1.3),
• heart failure (OR, 1.3),
• hypertension (OR, 1.3),
• arrhythmia (OR, 1.3),
• opioid prescription (OR, 1.3),
• anemia (OR, 1.2), and
• acute myocardial infarction (OR, 0.6). 

Researchers created a PAR-Risk Score, which they validated retrospectively in a cohort of patients admitted in 2013 and 2014.

“The PAR-Risk Score showed an acceptable ability to discriminate patients into low, medium, and high-risk categories,” researchers reported. “As a next step, therefore, we think that the PAR-Risk Score should be validated externally in order to confirm the interest of its use in detecting patients at a high risk of PAR.” —Jolynn Tumolo