Literature DB >> 33404804

Evaluation of early unplanned readmissions and predisposing factors in an oncology clinic.

Deniz Can Guven1, Furkan Ceylan2, Ibrahim Yahya Cakir2, Engin Cesmeci2, Basak Sayinalp2, Berkay Yesilyurt2, Gurkan Guner3, Hasan Cagri Yildirim3, Oktay Halit Aktepe3, Zafer Arik3, Alev Turker3, Omer Dizdar3.   

Abstract

BACKGROUND: Unplanned readmission in the first 30 days after discharge is an important medical problem, although the data on cancer patients is limited. So we planned to evaluate the rates and causes of early readmissions and the predisposing factors.
METHODS: Patients hospitalized in Hacettepe University Oncology services between August 2018 and July 2019 were included. The demographic features, tumor stages, regular drugs, last laboratory parameters before discharge, and readmissions in the first 30 days after discharge were recorded. The predisposing features were evaluated with univariate and multivariate analyses.
RESULTS: A total of 562 hospitalizations were included. The mean age of the patients was 58.5 ± 14.5 years. Almost 2/3 of the hospitalizations were due to symptom palliation and infections. Eighty-three percent of the patients had advanced disease, and over 60% had an ECOG score of 2 and above. In the first 30 days after discharge, 127 patients were readmitted (22.6%). Advanced stage disease, presence of polypharmacy (5 or more regular drugs), hospitalization setting (emergency department (ED) vs. outpatient clinic), and hypoalbuminemia (< 3 gr/dL) were associated with a statistically significant increase in the risk of readmission. Among these factors, advanced-stage disease (HR: 2.847, 95% CI: 1.375-5.895), hospitalization from ED (HR: 1.832, 95% CI: 1.208-2.777), and polypharmacy (HR: 1.782, 95% CI: 1.173-2.706) remained significant in multivariate analyses.
CONCLUSIONS: In this study, 22% of cancer patients had early readmissions. The readmission risk increased in patients with advanced disease, hospitalization from ED, and polypharmacy. The optimal post-discharge plan may reduce readmissions in all oncology patients, with priority for these patient groups.

Entities:  

Keywords:  Cancer; Polypharmacy; Post-discharge plan; Readmission

Year:  2021        PMID: 33404804     DOI: 10.1007/s00520-020-05927-7

Source DB:  PubMed          Journal:  Support Care Cancer        ISSN: 0941-4355            Impact factor:   3.603


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Journal:  PLoS One       Date:  2015-03-26       Impact factor: 3.240

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