The Impact of Weight Loss Prior to Hospital Readmission

Abstract

Hospital readmissions place a burden on hospitals. Reducing the readmission number and duration will help reduce the burden. Weight loss might affect readmission risk, especially the risk of an early (<30 days) readmission. This study sought to identify the predictors and the impact of weight loss prior to a delayed readmission (>30 days). Body mass index (BMI) was measured during the index admission and first readmission. Patients, after their readmission, were assessed retrospectively to identify the characteristics of those who had lost >5% weight prior to that readmission. Length of stay (LOS), time spent in the intensive care unit (ICU) and the one-year mortality of those patients who lost weight were compared to the outcomes of those who remained weight-stable using multilevel mixed-effects regression adjusting for BMI, Charlson comorbidity index (CCI), ICU hours and relative stay index (RSI). Those who were at risk of weight loss prior to readmission were identifiable based upon their age, BMI, CCI and LOS. Of 1297 patients, 671 (51.7%) remained weight-stable and 386 (29.7%) lost weight between admissions. During their readmission, those who had lost weight had a significantly higher LOS (IRR 1.17; 95% CI 1.12, 1.22: p < 0.001), RSI (IRR 2.37; 95% CI 2.27, 2.47: p < 0.001) and an increased ICU LOS (IRR 2.80; 95% CI 2.65, 2.96: p < 0.001). This study indicates that weight loss prior to a delayed readmission is predictable and leads to worse outcomes during that readmission.