Janina Wilmskoetter1, Kit N Simpson2, Heather S Bonilha3. 1. Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina. 2. Department of Healthcare Leadership and Management, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina. 3. Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina. Electronic address: bonilhah@musc.edu.
Abstract
OBJECTIVES: A critical mission of acute care hospitals is to reduce hospital readmissions to improve patient care and avoid monetary penalties. We speculated that stroke patients with enteral tube feeding are high-risk patients and sought to evaluate their hospital readmissions. METHODS: We analyzed archival hospital billing data from stroke patients discharged from acute care hospitals in Florida in 2012 for 30- and 60-day readmission rates, 30-day readmission rates by discharge destination, most frequent primary readmission diagnoses, and predictors of 30-day readmissions. We conducted univariate and multivariable logistic regression analyses. RESULTS: We analyzed 26,774 discharge records. Within 30 days after discharge, 21.06% (N = 299) of stroke patients with percutaneous endoscopic gastrostomy (PEG) tube placement were rehospitalized. Of those readmissions, 11.71% (N = 35) were preventable. Among stroke patients with a PEG tube placement, 53.80% were discharged to skilled nursing facilities and 27.88% were rehospitalized within 30 days. Septicemia was the most frequent primary readmission diagnosis. Comorbidities, stroke type, length of hospital stay, and discharge destinations were predictive for 30-day readmissions (area under the receiver operating characteristic curve was .81). CONCLUSIONS: Stroke patients with a PEG tube placement during their index hospital stay are twice as likely to be readmitted within 30 days compared to stroke patients without PEG tube placements. The primary readmission diagnosis for some patients was directly linked to PEG tube complications. We have identified risk factors that can be used to focus resources for readmission prevention.
OBJECTIVES: A critical mission of acute care hospitals is to reduce hospital readmissions to improve patient care and avoid monetary penalties. We speculated that strokepatients with enteral tube feeding are high-risk patients and sought to evaluate their hospital readmissions. METHODS: We analyzed archival hospital billing data from strokepatients discharged from acute care hospitals in Florida in 2012 for 30- and 60-day readmission rates, 30-day readmission rates by discharge destination, most frequent primary readmission diagnoses, and predictors of 30-day readmissions. We conducted univariate and multivariable logistic regression analyses. RESULTS: We analyzed 26,774 discharge records. Within 30 days after discharge, 21.06% (N = 299) of strokepatients with percutaneous endoscopic gastrostomy (PEG) tube placement were rehospitalized. Of those readmissions, 11.71% (N = 35) were preventable. Among strokepatients with a PEG tube placement, 53.80% were discharged to skilled nursing facilities and 27.88% were rehospitalized within 30 days. Septicemia was the most frequent primary readmission diagnosis. Comorbidities, stroke type, length of hospital stay, and discharge destinations were predictive for 30-day readmissions (area under the receiver operating characteristic curve was .81). CONCLUSIONS:Strokepatients with a PEG tube placement during their index hospital stay are twice as likely to be readmitted within 30 days compared to strokepatients without PEG tube placements. The primary readmission diagnosis for some patients was directly linked to PEG tube complications. We have identified risk factors that can be used to focus resources for readmission prevention.
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Marlís González-Fernández; Michael Gardyn; Shamolie Wyckoff; Paul K S Ky; Jeffrey B Palmer Journal: Dysphagia Date: 2009-04-28 Impact factor: 3.438
Authors: Pamela S Roberts; Margaret A DiVita; Richard V Riggs; Paulette Niewczyk; Brittany Bergquist; Carl V Granger Journal: PM R Date: 2013-08-22 Impact factor: 2.298
Authors: Anand Rajan; Peerapol Wangrattanapranee; Jonathan Kessler; Trilokesh Dey Kidambi; James H Tabibian Journal: World J Gastrointest Surg Date: 2022-04-27
Authors: Amit Kumar; Linda Resnik; Amol Karmarkar; Janet Freburger; Deepak Adhikari; Vincent Mor; Pedro Gozalo Journal: Arch Phys Med Rehabil Date: 2019-01-24 Impact factor: 3.966
Authors: Shirley L Shih; Marisa Flavin; Richard Goldstein; Chloe Slocum; Colleen M Ryan; Aneesh Singhal; Jason Frankel; Ross Zafonte; Jeffrey C Schneider Journal: Am J Phys Med Rehabil Date: 2020-01 Impact factor: 3.412