Hospital readmission after an acute admission to internal medicine: Causes and risk factors in a tertiary care center in Saudi Arabia.

Abstract

Objectives: To investigate the risk factors associated with single and multiple hospital readmissions within 30 days of discharge.

Methods: A retrospective study carried out during 2019 at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Using simple random sampling with an estimated prevalence of readmission rates between 10-20%, the calculated sample size was 200 patients. Patients were classified into 2 categories: patients with single or multiple readmissions. For comparison of categorical variables, the Chi-square test and Fisher's exact test were employed as relevant. Means comparisons were carried out using independent samples t-test. Multivariate logistic regression analysis was implemented to identify factors associated with multiple readmissions.

Results: The rate of readmission in hospital patients was 10.18%. A significant burden of comorbidities was observed with diabetes, hypertension, and heart failure being the most prevalent diseases. Multiple readmissions were observed in 18% of the total readmissions, predominantly for conditions related to the initial hospitalization. Age (odds ratio [OR]=1.057, 95% confidence interval [CI]: [1.005-1.108]; p=0.030), ejection fraction (OR=0.925; 95% CI: [0.873-0.980]; p=0.008), depression (OR=1.396; 95% CI: [0.3072-26.957]; p=0.049), and previous stroke (OR=0.236, 95% CI: [0.062-0.903]; p=0.035) were identified as independent predictors of multiple readmissions.

Conclusion: We found a high burden of comorbidities among patients requiring multiple readmissions. Older age, heart failure and ejection fraction, stroke, and depression were identified as risk factors for multiple readmissions. With interventions tailored to at-risk populations, we hypothesize that better utilization of available resources is achievable to reduce readmissions.