Patient selection: hospital discharge after admission for pulmonary embolism in a person living in Pennsylvania
Outcome: readmission within 30 days (in 14%)
Most common diagnoses at readmission included:
(1) recurrent thromboembolism (22%)
(2) bleeding (5%)
(3) pneumonia (5%)
(4) cancer (11%)
The remainder showed a wide range of conditions (40% were “other”).
Independent risk factors for readmission with odds ratios > 2:
(1) leaving hospital against medical advice (OR 2.8)
(2) pulmonary embolism severity index (PESI) risk class V (OR 2.04)
Independent risk factors for readmission with odds ratios from 1.4 to 2:
(1) PESI risk class III (OR 1.4) or class IV (OR 1.9)
(2) discharge home with supplemental care OR 1.4)
(3) Medicaid (OR 1.5)
Independent risk factors for readmissin with odds ratios less than 1.4:
(1) African American (OR 1.2), with OR 1.6 for venous thromboembolism
(2) no insurance (OR 1.15)
(3) PESI risk class II (OR 1.2)
(4) hospital region Philadelphia (OR 1.13)
The lowest rate of readmission were seen in central Pennsylvania (OR 0.73).
Compliance with discharge instructions was not listed as a study variable.
Comorbidity appeared to be high.
