Identifying Risk of Readmission in Hospitalized Elderly Adults Through Inpatient Medication Exposure

• Autores: Juliessa M. Pavon, Yangfang Zhao, Eleanor S. McConnell, S. Nicole Hastings
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 6, 2014, págs. 1116-1121
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Objective: To use electronic health record (EHR) data to examine the association between inpatient medication exposure and risk of hospital readmission.

    Design: Retrospective, observational study.

    Setting: Tertiary and quaternary care academic health system in Durham, North Carolina.

    Participants: All individuals aged 60 and older who were residents of Durham County, North Carolina and were hospitalized and discharged alive from Duke University Hospital between 2007 and 2009 (N = 4,627).

    Measurements: Independent variables were inpatient exposure to individual medication classes. Primary outcome was readmission to a Duke Health System hospital within 30 days.

    Results: Readmission rate was 21% (n = 955). In adjusted models, exposure to anticonvulsants (odds ratio OR 1.26, 95% confidence interval (CI) = 1.08�1.48), benzodiazepines (OR = 1.23, 95% CI = 1.04�1.44), corticosteroids (OR = 1.26, 95% CI = 1.07�1.50), and opioids (OR = 1.25, 95% CI = 1.06�1.47) was associated with greater likelihood of readmission. Exposure to antidepressants (OR = 1.85, 95% CI = 1.16�2.96) and opioids on the cardiology service (OR = 1.76, 95% CI = 1.01�3.07) and exposure to opioids on the medicine service (OR = 1.94, 95% CI = 1.17�3.22) were associated with greater odds of readmission than for individuals on the surgery service.

    Conclusion: Exposure of hospitalized elderly adults to certain medication classes was associated with greater likelihood of readmission. Incorporating medication data from EHRs may improve the performance of hospital readmission prediction models.