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  • Author
    Laura Hernandez Santiago
  • Co-author

    Roberto B. Vargas, MD, MPH

  • Title

    Predictors of Hospital Readmissions in Adult Patients with Sickle Cell Disease

  • Abstract

    Background: Sickle cell disease (SCD) is the most common inherited blood disorder, affecting primarily Black and Hispanic individuals. In 2016 30-day readmissions incurred 95,445 extra days of hospitalization and $152 million in total hospitalization costs. 

    Objectives: We describe and identify factors that are associated with readmission within 30 days in patients with SCD.

    Methods: We conducted a retrospective observational study of patients with sickle cell disease hospitalized in California between 2005 and 2014. We present descriptive statistics and logistic regression models examining significant differences in characteristics of patients and their association with hospital readmissions in adults with SCD.

    Results: From a total of 2,728 index admissions at the individual level, 70% of those admissions were classified as single admission, 10% had 1 readmission, and 20% had ≥ 2 readmissions within 30 days of an index admission. Significant predictors associated with 0 vs 1 readmission were those who identified as Males (OR 1.37, CI 1.06-1.77), Black (OR 3.27, CI 1.71-6.27) and those having Medicare (OR 1.89, CI 1.30-2.75). Lower likelihood of readmission was found in those with a Charlson Comorbidity index of 3 or more (OR 0.53, CI 0.29-0.97). Significant predictors associated with 0 vs ≥ 2 readmissions were those who identified as Males (OR 1.43, CI 1.17-1.74), Black (OR 6.90, CI 3.41-13.97), Hispanic (OR 2.33, CI 1.05-5.17) had Medicare (OR 3.58, CI 2.68-4.81) or Medical (OR 1.70 CI 1.31-2.20). Lower likelihood for having 2 or more readmissions were increasing age/65+ (OR 0.97, CI 0.96-0.98) and self-payer status (OR 0.32, CI 0.12-0.54).

    Conclusions: Individuals who are males, Black, or those who have Medicare were more likely to have at least one readmission within 30-days of their index admission. Our findings support similar studies of 30-day readmissions in patients with SCD.

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