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Factors Predicting 90-Day Readmissions for US Older Adult Burn Patients From the 2016-2018 Nationwide Readmissions Database.
Yi, Yangtian; Vrouwe, Sebastian Q; Gottlieb, Lawrence J; Rubin, Daniel S.
Afiliación
  • Yi Y; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
  • Vrouwe SQ; Section of Plastic & Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, IL 60637, USA.
  • Gottlieb LJ; Section of Plastic & Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, IL 60637, USA.
  • Rubin DS; Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL 60637, USA.
J Burn Care Res ; 45(3): 709-718, 2024 05 06.
Article en En | MEDLINE | ID: mdl-38363318
ABSTRACT
Older adults with burn injuries have a high risk of readmission after the initial burn admission. Frailty is associated with poor outcomes from the initial burn injury, however, it remains unknown if frailty impacts readmission in older adults after the initial index burn admission. Our study aims to examine patient, frailty, burn, surgical, and hospital factors that contribute to 90-day readmissions in older adults with an acute burn. Patients ≥ 50 years of age with an acute burn diagnosis in the Nationwide Readmissions Database (2016-2018) were included. Patients who died during index admissions were excluded from the readmission analysis. Patient, burn, hospital stay, and hospital characteristics were analyzed. Using variables significant from univariate logistic regression analysis, we performed a multivariable logistic regression analysis to identify factors associated with 90-day readmissions. A total of 41,500 weighted index burn admissions were included. The 90-day readmission rate was 25.6% (10,641/41,500). Almost all the readmissions were unplanned (96.5%). The most common primary readmission diagnoses based on Clinical Classifications Software Refined were burn injury and septicemia. Multivariable logistic regression analysis demonstrated an increased hospital frailty risk and lower-body-only burns were associated with an increased risk of readmission. Notably, surgical treatment of the burn injury during the index admission was associated with a decreased risk of readmission. This highlights the importance and challenges of surgical decision-making for older adults with high comorbidity burden. Future studies are needed to develop decision guides to help clinicians identify patients who would benefit from surgical treatment versus more conservative strategies in older adult patients with burns.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Quemaduras Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Burn Care Res Asunto de la revista: TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Readmisión del Paciente / Quemaduras Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Burn Care Res Asunto de la revista: TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido