The association between pre-discharge factors and early unplanned readmissions in adult home mechanical ventilation patients in Taiwan.

Background: Purpose: Home mechanical ventilation offers significant benefits, but hospital readmissions remain a challenge, with rates as high as 20-40 % and associated mortality. While some studies have investigated risk factors for readmission, pre-discharge factors influencing unplanned readmissions in this population remain unclear. This study aimed to identify pre-discharge factors associated with unplanned hospital readmissions in home-ventilated patients.

Methods: A 60-month retrospective cohort study was conducted, including patients receiving home mechanical ventilation. Demographic, respiratory, physiological, and laboratory parameters near discharge were collected. Readmissions were categorized as occurring within 30 days and beyond to identify pre-discharge factors associated with unplanned hospital readmissions.

Results: Among a cohort of 6925 mechanically ventilated patients, 913 were readmitted. Of these, 127 were unplanned readmissions, with an average age of 70 years, predominantly female (68 subjects), and 33.1 % occurred within 30 days post-discharge. Logistic regression analysis identified cardiovascular disease, maximum inspiratory pressure, and low hemoglobin levels as significant predictors of early unplanned readmissions within 30 days.

Conclusion: Unplanned hospital readmissions pose a considerable challenge for home-ventilated patients, particularly within the first 30 days post-discharge. Pre-discharge factors, including cardiovascular disease, low inspiratory muscle performance as assessed by PImax, and low hemoglobin levels, are key risk factors. Addressing these factors during discharge planning is crucial to reducing early readmissions and improving patient outcomes and resource allocation in healthcare.