Prediction of Early and Long-Term Hospital Readmission in Patients with Severe Obesity: A Retrospective Cohort Study

Author:

Bioletto Fabio1ORCID,Evangelista Andrea2,Ciccone Giovannino2,Brunani Amelia3ORCID,Ponzo Valentina1,Migliore Enrica2,Pagano Eva2,Comazzi Isabella1,Merlo Fabio Dario4,Rahimi Farnaz4,Ghigo Ezio1ORCID,Bo Simona1ORCID

Affiliation:

1. Department of Medical Sciences, University of Turin, 10126 Turin, Italy

2. Unit of Clinical Epidemiology, CPO, Città della Salute e della Scienza Hospital, 10126 Turin, Italy

3. Rehabilitation Medicine Unit, IRCCS Istituto Auxologico Italiano Piancavallo, 28824 Oggebbio, Italy

4. Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy

Abstract

Adults with obesity have a higher risk of hospitalization and high hospitalization-related healthcare costs. However, a predictive model for the risk of readmission in patients with severe obesity is lacking. We conducted a retrospective cohort study enrolling all patients admitted for severe obesity (BMI ≥ 40 kg/m2) between 2009 and 2018 to the Istituto Auxologico Italiano in Piancavallo. For each patient, all subsequent hospitalizations were identified from the regional database by a deterministic record-linkage procedure. A total of 1136 patients were enrolled and followed up for a median of 5.7 years (IQR: 3.1–8.2). The predictive factors associated with hospital readmission were age (HR = 1.02, 95%CI: 1.01–1.03, p < 0.001), BMI (HR = 1.02, 95%CI: 1.01–1.03, p = 0.001), smoking habit (HR = 1.17, 95%CI: 0.99–1.38, p = 0.060), serum creatinine (HR = 1.22, 95%CI: 1.04–1.44, p = 0.016), diabetes (HR = 1.17, 95%CI: 1.00–1.36, p = 0.045), and number of admissions in the previous two years (HR = 1.15, 95%CI: 1.07–1.23, p < 0.001). BMI lost its predictive role when restricting the analysis to readmissions within 90 days. BMI and diabetes lost their predictive roles when further restricting the analysis to readmissions within 30 days. In conclusion, in this study, we identified predictive variables associated with early and long-term hospital readmission in patients with severe obesity. Whether addressing modifiable risk factors could improve the outcome remains to be established.

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

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