Jeffrey Mather|Gilbert Fortunato|Jenifer L Ash|Michael J. Davis|Ajay Kumar
Prediction of Pneumonia 30-Day Readmissions: A Single-Center Attempt to Increase Model Performance
Hartford Hospital
h3backgroundh3 existing models developed predict 30 days readmissions pneumonia lack discriminative ability attempted increase model performance addition variables found benefit studies h3methodsh3 133368 admissions tertiarycare hospital january 2009 march 2012 study cohort consisted 956 index admissions pneumonia using centers medicare medicaid services definition collected variables previously reported associated 30day allcause readmission including vital signs comorbidities laboratory values demographics socioeconomic indicators indicators hospital utilization separate logistic regression models developed identify predictors allcause hospital readmission 30 days discharge index pneumonia admission pneumoniarelated readmissions pneumoniaunrelated readmissions h3resultsh3 965 index admissions pneumonia 148 155 subjects readmitted within 30 days variables multivariatemodel significantly associated 30day allcause readmission male sex odds ratio 159 95 ci 103245 3 previous admissions odds ratio 184 95 ci 122278 chronic lung disease odds ratio 163 95 ci 107248 cancer odds ratio 218 95 ci 124384 median income lt 43000 odds ratio 182 95 ci 118281 history anxiety depression odds ratio 162 95 ci 104252 hematocrit lt 30 odds ratio 186 95 ci 107322 model performance measured c statistic 071 066075 minimal optimism according bootstrap resampling optimism corrected c statistic 067 h3conclusionsh3 addition socioeconomic status healthcare utilization variables significantly improved model performance compared model using centers medicare medicaid services variables