Format

Send to

Choose Destination
Clin Gastroenterol Hepatol. 2011 Feb;9(2):175-80; quiz e18. doi: 10.1016/j.cgh.2010.08.017. Epub 2010 Sep 9.

A scoring system to predict readmission of patients with acute pancreatitis to the hospital within thirty days of discharge.

Author information

1
Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. Tom_Whitlock@post.harvard.edu

Abstract

BACKGROUND & AIMS:

Reducing rapid readmission of patients after discharge could improve quality of treatment and reduce costs. Little is known about clinical predictors of early readmission for acute pancreatitis (AP). We developed a strategy to identify and stratify patients with AP at risk for readmission within 30 days of discharge.

METHODS:

We derived and validated a model in a cohort of patients hospitalized with AP from June 2005-October 2009. Early readmission was defined as admission to the hospital or reevaluation in the emergency department within 30 days of discharge. The cohort was divided into a derivation cohort (admitted June 2005-December 2007, n = 248) and a validation cohort (admitted January 2008-October 2009, n = 198). A weighted scoring system was developed using logistic regression for the prediction of early readmission. Accuracy was assessed by area under the receiver-operator characteristic (ROC) curve analysis.

RESULTS:

Of the total patients, 21% (92/446) had early readmission. Multivariable analysis identified the following discharge characteristics as independent risk factors for early readmission: gastrointestinal symptoms, eating less than a solid diet, pancreatic necrosis, treatment with antibiotics, and pain (P < .05). Weighted risk scores stratified patients into groups of low, moderate, and high risk for early readmission: 4%, 15%, and 87%, respectively, in the derivation cohort and 5%, 18%, and 68%, respectively, in the validation cohort. Area under the ROC curve demonstrated an accurate prediction (c-statistic = 0.83).

CONCLUSIONS:

We created a scoring system that accurately predicts which patients with AP have high and low risk of readmission within 30 days of discharge.

PMID:
20832502
DOI:
10.1016/j.cgh.2010.08.017
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center