Predictors of 30-day Unplanned Hospital Readmissions among Maintenance Dialysis Patients

Abstract

Background and Objectives. Patients on dialysis are twice as likely to have early readmissions. This study aimed to identify risk factors for 30-day unplanned readmission among patients on maintenance dialysis in a tertiary hospital.

Methods. We conducted a retrospective, unmatched, case-control study. Data were taken from patients on
maintenance hemodialysis admitted in the University of the Philippines–Philippine General Hospital (UP-PGH)
between January 2018 and December 2020. Patients with 30-day readmission were included as cases and patients with >30-day readmissions were taken as controls. Multivariable regression with 30-day readmission as the outcome was used to identify significant predictors of early readmission.

Results. The prevalence of 30-day unplanned readmission among patients on dialysis is 36.96%, 95%CI [31.67,
42.48]. In total, 119 cases and 203 controls were analyzed. Two factors were significantly associated with early
readmission: the presence of chronic glomerulonephritis [OR 2.35, 95% CI 1.36 to 4.07, p-value=0.002] and number of comorbidities [OR 1.34, 95% CI 1.12 to 1.61, p-value=0.002]. The most common reasons for early readmission are infection, anemia, and uremia/underdialysis.

Conclusion. Patients with chronic glomerulonephritis and multiple comorbidities have significantly increased odds of early readmission. Careful discharge planning and close follow up of these patients may reduce early readmissions.