1505MO - Evaluation of early unplanned readmissions and predisposing factors in an oncology clinic

Background

Unplanned readmission in the first 30 days after discharge is an important medical problem and regarded as a quality indicator. However, data on readmissions in oncology services is still limited. So, we planned to evaluate the rates and causes of early readmissions and the predisposing factors in our institution.

Methods

Patients who were hospitalized in Hacettepe University Oncology services between 01.08.2018-31.07.2019 were included. The patients' demographic features, tumor stages, regularly used drugs, comorbidities, last complete blood count and biochemistry parameters, presence and reasons for 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 in the analyses. The median age of the patients was 61 (19-96). Almost two-thirds of the hospitalizations were due to symptom palliation and infections. 83% of the patients had advanced disease and over 60% had an ECOG performance score of 2 and above. In the first 30 days after discharge, 127 patients were readmitted to the hospital (22.6%). Of these readmissions, 56 (44.1%) were direct to inpatient service, 61 (48%) were to the emergency department, and 10 (7.9%) were intensive care hospitalizations. In 39 patients (30.7%), the reason for first hospitalization and readmission was the same. Advanced stage disease (stage 4 vs 1-3), presence of polypharmacy (5 or more regular drugs), emergency hospitalization (emergency vs. ambulatory), 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), emergency hospitalization (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 the oncology patients had readmission in the first 30 days after discharge. The readmission risk increased significantly in patients with advanced disease, emergency hospitalization, and polypharmacy. The optimal post-discharge plan may reduce readmissions in all oncology patients, with priority for these patient groups.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.