Derivation and validation of a predictive model for the readmission of patients with diabetes mellitus treated in internal medicine departments
Por:
Ena J, Gómez-Huelgas R, Gracia-Tello BC, Vázquez-Rodríguez P, Alcalá-Pedrajas JN, Carrasco-Sánchez FJ, Murcia-Casas B, Romero-Sánchez M, Segura-Heras JV and Carretero J
Publicada:
1 ago 2018
Ahead of Print:
4 may 2018
Categoría:
Medicine (miscellaneous)
Resumen:
Objectives: We developed a predictive model for the hospital readmission of patients with diabetes. The objective was to identify the frail population that requires additional strategies to prevent readmissions at 90 days.
Methods: Using data collected from 1977 patients in 3 studies on the national prevalence of diabetes (2015-2017), we developed and validated a predictive model of readmission at 90 days for patients with diabetes.
Results: A total of 704 (36%) readmissions were recorded. There were no differences in the readmission rates over the course of the 3 studies. The hospitals with more than 500 beds showed significantly (p=.02) higher readmission rates than those with fewer beds. The main reasons for readmission were infectious diseases (29%), cardiovascular diseases (24) and respiratory diseases (14%). Readmissions directly related to diabetic decompensations accounted for only 2% of all readmissions. The independent variables associated with hospital readmission were patient's age, degree of comorbidity, estimated glomerular filtration rate, degree of disability, presence of previous episodes of hypoglycaemia, use of insulin in treating diabetes and the use of systemic glucocorticoids. The predictive model showed an area under the ROC curve (AUC) of 0.676 (95% confidence interval [95% cI] 0.642-0.709; p=.001) in the referral cohort. In the validation cohort, the model showed an AUC of 0.661 (95% CI 0.612-0.710; p=.001).
Conclusion: The model we developed for predicting readmissions for hospitalised patients with type 2 diabetes helps identify a subgroup of frail patients with a high risk of readmission. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Filiaciones:
:
Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Alicante, España
Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Alicante, Espana
Gómez-Huelgas R:
Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España
Servicio de Medicina Interna, Hospital Regional Universitario de Malaga, Malaga, Espana
Gracia-Tello BC:
Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
Servicio de Medicina Interna, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Espana
Vázquez-Rodríguez P:
Servicio de Medicina Interna, Complexo Hospitalario Universitario A Coruña, A Coruña, España
Servicio de Medicina Interna, Complexo Hospitalario Universitario A Coruna, A Coruna, Espana
Alcalá-Pedrajas JN:
Servicio de Medicina Interna, Hospital Comarcal de Pozoblanco, Pozoblanco, Córdoba, España
Servicio de Medicina Interna, Hospital Comarcal de Pozoblanco, Pozoblanco, Cordoba, Espana
Carrasco-Sánchez FJ:
Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, España
Servicio de Medicina Interna, Hospital Juan Ramon Jimenez, Huelva, Espana
Murcia-Casas B:
Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
Servicio de Medicina Interna, Hospital Clinico Universitario Virgen de la Victoria, Malaga, Espana
Romero-Sánchez M:
Servicio de Medicina Interna, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España
Servicio de Medicina Interna, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Espana
Segura-Heras JV:
Centro de Investigación Operativa, Universidad Miguel Hernández, Elche, Alicante, España
Centro de Investigacion Operativa, Universidad Miguel Hernandez, Elche, Alicante, Espana
Carretero J:
Servicio de Medicina Interna, Hospital Comarcal de Zafra, Zafra, Badajoz, España
Servicio de Medicina Interna, Hospital Comarcal de Zafra, Zafra, Badajoz, Espana
Open Access
FULL TEXT
 |
Published Version |
This policy does not allow for Open Access for this version |
| No Accesible |
|