Tool for Predicting Unplanned Readmission of Elderly Patient

 

Patient selection: >= 65 years of age (excluding patients with active malignancy, dialysis, and chronic mechanical ventilation) admitted to internal medicine ward

 

Outcome: unplanned readmission within 3 months

 

Parameters:

(1) age in years

(2) cognitive impairment

(3) residence

(4) congestive heart failure

(5) serum creatinine

Parameter	Finding	Points
age in years	< 80 years of age	0
	>= 80 years of age	1
cognitive impairment	none	0
	any	1
residence	home	0
	nursing home	1
congestive heart failure	absent	0
	presesnt	1
serum creatinine	<= 1.5 mg/dL	0
	> 1.5 mg/dL	1

 

where:

• The significance of serum creatinine is different in older adults, especially when there is reduced muscle mass.

score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the greater the risk for unplanned readmission.

• A score >= 3 was used to identify a patient at risk for unplanned readmission.

 

Performance:

• The positive predictive value was 80% (derivation) or 67% (validation).

• The sensitivity was 45% and specificity 85%.

• The AUC was 0.75.