Risk Factors of Readmissions in Geriatric Rehabilitation Patients: RESORT

Arch Phys Med Rehabil. 2021 Feb 16;S0003-9993(21)00152-0. doi: 10.1016/j.apmr.2021.01.082. Online ahead of print.

Abstract

Objective: To evaluate the risk factors associated with 30- and 90-day hospital readmissions in geriatric rehabilitation inpatients.

Design: Observational, prospective longitudinal inception cohort.

Setting: Tertiary hospital in Victoria, Australia.

Participants: Geriatric rehabilitation inpatients of the REStORing Health of Acutely Unwell AdulTs (RESORT) cohort evalutated by a comprehensive geriatric assessment including potential readmission risk factors (ie, demographic, social support, lifestyle, functional performance, quality of life, morbidity, length of stay in an acute ward). Of 693 inpatients, 11 died during geriatric rehabilitation. The mean age of the remaining 682 inpatients was 82.2±7.8 years, and 56.7% were women.

Interventions: Not applicable.

Main outcome measures: Thirty- and 90-day readmissions after discharge from geriatric inpatient rehabilitation.

Results: The 30- and 90-day unplanned all-cause readmission rates were 11.6% and 25.2%, respectively. Risk factors for 30- and 90-day readmissions were as follows: did not receive tertiary education, lower quality of life, higher Charlson Comorbidity Index and Cumulative Illness Rating Scale (CIRS) scores, and a higher number of medications used in the univariable models. Formal care was associated with increased risk for 90-day readmissions. In multivariable models, CIRS score was a significant risk factor for 30-day readmissions, whereas high fear of falling and CIRS score were significant risk factors for 90-day readmissions.

Conclusions: High fear of falling and CIRS score were independent risk factors for readmission in geriatric rehabilitation inpatients. These variables should be included in hospital readmission risk prediction model developments for geriatric rehabilitation inpatients.

Keywords: Aged; Geriatrics; Patient readmission; Rehabilitation; Risk factors.