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BACKGROUND: Reducing hospital readmission offer potential benefits for patients, providers, payers, and policymakers to improve quality of healthcare, reduce cost, and improve patient experience. We investigated effectiveness of remdesivir in reducing 30-day coronavirus disease 2019 (COVID-19)-related readmission during the Omicron era, including older adults and those with underlying immunocompromising conditions. METHODS: This retrospective study utilized the US PINC AI Healthcare Database to identify adult patients discharged alive from an index COVID-19 hospitalization between December 2021 and February 2024. Odds of 30-day COVID-19-related readmission to the same hospital were compared between patients who received remdesivir vs those who did not, after balancing characteristics of the two groups using inverse probability of treatment weighting (IPTW). Analyses were stratified by maximum supplemental oxygen requirement during index hospitalization. RESULTS: Of 326 033 patients hospitalized for COVID-19 during study period, 210 586 patients met the eligibility criteria. Of these, 109 551 (52%) patients were treated with remdesivir. After IPTW, lower odds of 30-day COVID-19-related readmission were observed in patients who received remdesivir vs those who did not, in the overall population (3.3% vs 4.2%, respectively; odds ratio [95% confidence interval {CI}]: 0.78 [.75-.80]), elderly population (3.7% vs 4.7%, respectively; 0.78 [.75-.81]), and those with underlying immunocompromising conditions (5.3% vs 6.2%, respectively; 0.86 [.80-.92]). These results were consistent irrespective of supplemental oxygen requirements. CONCLUSIONS: Treating patients hospitalized for COVID-19 with remdesivir was associated with a significantly lower likelihood of 30-day COVID-19-related readmission across all patients discharged alive from the initial COVID-19 hospitalization, including older adults and those with underlying immunocompromising conditions.

STUDY DESIGN: Retrospective review of multicentric data. OBJECTIVES: The modified 5-item frailty index is a relatively new tool to assess the post-operative complication risks. It has been recently shown a good predictive value after posterior lumbar fusion. We aimed to compare the predictive value of the modified 5-item frailty index in cervical, thoracic and lumbar surgery. METHODS: The American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) Database 2015-2020 was used to identify patients who underwent elective posterior cervical, thoracic, or lumbar fusion surgeries for degenerative conditions. The mFI-5 score was calculated based on the presence of 5 co-morbidities: congestive heart failure within 30 days prior to surgery, insulin-dependent or noninsulin-dependent diabetes mellitus, chronic obstructive pulmonary disease or pneumonia, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Multivariate analysis was used to assess the independent impact of increasing mFI-5 score on the postoperative morbidity while controlling for baseline clinical characteristics. RESULTS: 53 252 patients were included with the mean age of 64.2 ± 7.2. 7946 suffered medical complications (14.9%), 1565 had surgical complications (2.9%), and 3385 were readmitted (6.3%), 363 died (.68%) within 30 days postoperative (6.3%). The mFI-5 items score was significantly associated with higher rates of complications, readmission, and mortality in cervical, thoracic, and lumbar posterior fusion surgery. CONCLUSION: The modified 5-item frailty score is a reliable tool to predict complications, readmission, and mortality in patients planned for elective posterior spinal fusion surgery.

Aim: This observational study investigated the association between remdesivir treatment during hospitalization for COVID-19 and 30-day COVID-19-related and all-cause readmission across different variants time periods. Patients & methods: Hospitalization records for adult patients discharged from a COVID-19 hospitalization between 1 May 2020 to 30 April 2022 were extracted from the US PINC AI Healthcare Database. Likelihood of 30-day readmission was compared among remdesivir-treated and nonremdesivir-treated patients using multivariable logistic regression models adjusted for age, corticosteroid treatment, Charlson comorbidity index and intensive care unit stay during the COVID-19 hospitalization. Analyses were stratified by maximum supplemental oxygen requirement and variant time period (pre-Delta, Delta and Omicron). Results: Of the 440,601 patients discharged alive after a COVID-19 hospitalization, 248,785 (56.5%) patients received remdesivir. Overall, remdesivir patients had a 30-day COVID-19-related readmission rate of 3.0% and all-cause readmission rate of 6.3% compared with 5.4% and 9.1%, respectively, for patients who did not receive remdesivir during their COVID-19 hospitalization. After adjusting for demographics and clinical characteristics, remdesivir treatment was associated with significantly lower odds of 30-day COVID-19-related readmission (odds ratio 0.60 [95% confidence interval: 0.58-0.62]), and all-cause readmission (0.73 [0.72-0.75]). Significantly lower odds of 30-day readmission in remdesivir-treated patients was observed across all variant time periods. Conclusion: Treating patients hospitalized for COVID-19 with remdesivir is associated with a statistically significant reduction in 30-day COVID-19-related and all-cause readmission across variant time periods. These findings indicate that the clinical benefit of remdesivir may extend beyond the COVID-19 hospitalization.

Percutaneous coronary intervention (PCI) is a practical and effective method for treating coronary heart disease (CHD). This study aims to explore the influencing factors of major cardiovascular events (MACEs) and hospital readmission risk within one year following PCI treatment. Additionally, it seeks to assess the clinical value of Apolipoprotein B/Apolipoprotein A-I (ApoB/ApoA-I) in predicting the risk of one-year MACEs and readmission post-PCI. A retrospective study included 1938 patients who underwent PCI treatment from January 2010 to December 2018 at Shandong Provincial Hospital affiliated with Shandong First Medical University. Patient demographics, medications, and biochemical indicators were recorded upon admission, with one-year follow-up post-operation. Univariate and multivariate Cox proportional hazards regression models were utilized to establish the relationship between ApoB/ApoA-I levels and MACEs/readmission. Predictive nomograms were constructed to forecast MACEs and readmission, with the accuracy of the nomograms assessed using the concordance index. Subgroup analyses were conducted to explore the occurrence of MACEs and readmission. We observed a correlation between ApoB/ApoA-I and other lipid indices, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) (P < 0.001). Univariate and multivariate Cox regression analyses demonstrated that ApoB/ApoA-I is an independent risk factor for MACEs in post-PCI patients (P = 0.038). Within one year, the incidence of MACEs significantly increased in the high-level ApoB/ApoA-I group (ApoB/ApoA-I ratio ≥ 0.824) (P = 0.038), while the increase in readmission incidence within one year was not statistically significant. Furthermore, a nomogram predicting one-year MACEs was established (Concordance Index: 0.668). Subgroup analysis revealed that ApoB/ApoA-I was associated with the occurrence of both MACEs and readmission in male patients, those using CCB/ARB/ACEI, those without multivessel diseases, or those with LDL-C < 2.6 mmol/L. The ApoB/ApoA-I ratio serves as an independent risk factor for one-year MACEs in post-PCI patients and correlates closely with other blood lipid indicators. ApoB/ApoA-I demonstrates significant predictive value for the occurrence of MACEs within one year. Trial registration Chinese clinical trial registry: No.ChiCTR22000597-23. [ABSTRACT FROM AUTHOR]

Background: Despite extensive research on COVID-19 and its association with myocarditis, limited data are available on readmission rates for this subset of patients. Thirty-day hospital readmission rate is an established quality metric that is associated with increased mortality and cost. Methods: This retrospective analysis utilized the Nationwide Readmission Database for the year 2020 to evaluate 30-day hospital readmission rates, risk factors, and clinical outcomes among COVID-19 patients who presented with myocarditis at their index hospitalization. Results: Our analysis revealed that 1) the 30-day all-cause hospital readmission rate for patients initially hospitalized with COVID-19 and myocarditis was 11.7%; 2) after multivariate adjustment, the primary predictor of readmission for COVID-19 patients with myocarditis was discharge against medical advice; 3) COVID-19 patients with myocarditis who required readmission had a higher proportion of older patients and Medicare beneficiaries; 4) the most common diagnoses at readmission were COVID-19, sepsis, congestive heart failure, acute myocardial infarction, and pneumonia; and 5) readmitted patients were more likely to require renal replacement therapy during their index hospitalization. Conclusion: This study underscores the importance of optimizing discharge plans, preventing irregular discharges through shared decision-making, and ensuring robust post-hospital follow-up for patients with COVID-19 and myocarditis at index admission. [ABSTRACT FROM AUTHOR]

Purpose: Perioperative intravenous different doses of dexamethasone (DEX) can realize effective clinical outcomes in total joint arthroplasty (TJA). However, the effect of different DEX doses on readmission rates and postoperative complications remains unclear. Methods: We retrospectively analyzed patients who underwent primary TJA between December 2012 and October 2020. Patients were categorized into three groups based on the total perioperative dose of DEX: control group (DEX = 0 mg), low-dose group (DEX < 15 mg), and high-dose group (DEX ≥ 15 mg). Primary outcomes included 30-day and 90-day readmission rates. Secondary outcomes included the rates of periprosthetic joint infection (PJI) and wound complications, with treatment outcomes for these complications were also evaluated. Multivariable analysis was used to identify risk factors for readmission. Results: A total of 14,557 procedures were included, with 6,686 in the control group, 4,325 in the low-dose group, and 3,546 in the high-dose group. No significant differences were observed among the groups for 30-day (p = 0.645) or 90-day readmission rates (p = 0.539). Additionally, there were no significant differences in rates of PJI (p = 0.401) or wound complications (p = 0.079). Treatment for PJI and wound complications was successful across all groups. Risk factors for 30-day readmission included age > 80 years (OR: 2.585, 95% CI: 1.123–5.954, p = 0.026) and undergoing total hip arthroplasty (THA) (OR: 1.692, 95% CI: 1.137–2.518, p = 0.009). For 90-day readmission, age 71–80 years (OR: 2.199, 95% CI: 1.349–3.583, p = 0.002), age > 80 years (OR: 3.897, 95% CI: 1.966–7.727, p < 0.001), and THA (OR: 1.622, 95% CI: 1.179–2.230, p = 0.003) were significant risk factors. However, neither low-dose nor high-dose DEX was associated with increased 30-day or 90-day readmission rates. Conclusions: Perioperative intravenous DEX may be not associated with the readmission, PJI, and wound complications in patients undergoing primary TJA. [ABSTRACT FROM AUTHOR]

Background: Frequent exacerbations of bronchiectasis lead to poor quality of life, impaired lung function, and higher mortality rates. This study aims to evaluate the risk factors associated with readmission within one year due to acute exacerbation of bronchiectasis (AEB). Methods: A retrospective cohort study was performed on 260 patients with bronchiectasis who were hospitalized in the respiratory and critical care department of a tertiary hospital in China. Univariate and multivariate Cox analyses were used to evaluate the risk factors for readmission within one year. Results: Readmission within one year was found in 44.6% of 260 patients hospitalized with acute exacerbation of bronchiectasis. The risk factors associated with readmission included age over 65 years (HR = 3.66; 95% CI: 2.30 to 5.85), BMI < 18.5 kg/m2 (HR = 1.71; 95% CI: 1.16 to 2.51), respiratory intensive care unit (RICU) stay during admission (HR = 2.06, 95% CI: 1.16–3.67), involvement of 3 or more lobes on chest high-resolution computed tomography (HRCT) (HR = 1.85; 95% CI, 1.22 to 2.80), chronic Pseudomonas aeruginosa (PA) colonization (HR = 2.29; 95% CI: 1.54 to 3.38), and positive sputum culture results within 24 h after admission (HR = 1.93; 95% CI: 1.27 to 2.94). Long-term oral antibiotics use after discharge was associated with decreased hazard of readmission (HR = 0.34; 95% CI: 0.20 to 0.59). Conclusions: Patients with bronchiectasis have a high rate of readmission, which is linked to varieties of risk factors, and identifying these risk factors is importance for effectively managing patients with bronchiectasis. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper was to estimate the impact of country-wide hospital pay-for-performance on readmissions for a set of common conditions in Lebanon. Methods: This retrospective cohort study included all hospitalizations under the coverage of the Ministry of Public Health in Lebanon between 2011 and 2019. We calculated 30-day all-cause readmissions following general, pneumonia, cholecystectomy and stroke cases. We used an interrupted time series design, including the use of AutoRegressive Integrated Moving Average models. This nationwide study including 1,333,691 hospitalizations was undertaken in Lebanon, using hospitalizations at about 140 private and public hospitals contracted by the Ministry. The participants included citizens across all ages under the Ministry's coverage (52% of citizens). The intervention was the engagement of hospital leaders by the Ministry, informing them of the addition of a readmissions component to the ongoing pay-for-performance initiative. Engagement participants included hospital directors and managers, and the leadership of the Syndicate of Private Hospitals. The main outcome measure was age-adjusted monthly all-cause readmission rates for each of general, pneumonia, cholecystectomy and stroke cases. We also assessed for change in readmissions for three conditions not included in the intervention (myocardial infarction, cataract surgery and appendectomy). Results: Across 2011–2019, the overall readmission rates were 6.00% (SD 0.24%) for general readmissions, 5.06% (SD 0.22%) for pneumonia, 2.54% (SD 0.16%) for cholecystectomy, and 6.55% (SD 0.25%) for stroke. Using ARIMA models we found a relative percentage decrease in mean monthly readmissions in the post-intervention period for cholecystectomy (5.9%; CI 0.1%-11.8%) and stroke (13.6%; CI 3.1%-24.2%). There was no evidence of intervention impact on pneumonia and general readmissions, both overall and among small, medium and large hospitals. There was also no evidence of change in non-P4P readmissions of myocardial infarction, cataract surgery and appendectomy. Conclusions: Including readmissions within pay-for-performance has the potential to improve hospital performance and patient outcomes, even in countries with more limited resources. Effects may vary across conditions, indicating the need for careful design and understanding of the particular context, both with respect to implementation and to evaluation of impact. [ABSTRACT FROM AUTHOR]

Readmissions are an indicator of hospital care quality; a high readmission rate is associated with adverse outcomes. This leads to an increase in healthcare costs and quality of life for patients. Developing predictive models for hospital readmissions provides opportunities to select treatments and implement preventive measures. The aim of this study is to develop predictive models for the readmission risk of patients with schizophrenia, combining the particle swarm optimization (PSO) algorithm with machine learning classification algorithms. The database used in the study includes a total of 6089 readmission records of patients with schizophrenia. These records were collected from 11 public hospitals in Castilla and León, Spain, in the period 2005–2015. The results of the study show that the Random Forest algorithm combined with PSO achieved the best results across the evaluated performance metrics: AUC = 0.860, recall = 0.959, accuracy = 0.844, and F1-score = 0.907. The development of these new models contributes to -improving patient care. Additionally, they enable preventive measures to reduce costs in healthcare systems. [ABSTRACT FROM AUTHOR]

Objective: Aspiration pneumonia (AP) is an important subset of pneumonia in elderly. This study aimed to identify risk factors affecting hospital length of stay (LoS), mortality, and readmission in patients with AP. Materials and Methods: This retrospective observational study analyzed data from 263 patients hospitalized with a diagnosis of AP (n=133) and community-acquired pneumonia (n=130) between December 2020 and November 2023. Results: Dementia/Parkinson's disease (p<0.001), cerebrovascular accident (p<0.001), motor neuron disease (p<0.001), polypharmacy (p<0.001) and sedative drug usage (p<0.001) were common in AP patients as risk factors for aspiration. Additionally, LoS (p<0.001), mortality (p<0.001) and readmission (p<0.001) were common in the AP group. Readmission mortality for the AP group was 57.1%. Multivariate analyses of factors contributing to increased LoS were the presence of a caregiver (p=0.014), need for intensive care unit (ICU) during hospitalization (p=0.006), ICU LoS (p<0.001) and hospital admission within the last 90 days (p=0.02). Risk factors for readmission included high Charlson Comorbidity Index (CCI) (p=0.032), fever at admission (p=0.008) and ICU need during hospitalization (p=0.028). For in-hospital mortality, a lower body mass index (BMI) (p=0.01), more than one caregiver (p=0.045) and increased hospital LoS (p=0.028) were identified as independent risk factors. Conclusion: Extended hospitalization for AP is associated with the recent hospitalization, need for care, ICU admission requirement, and prolonged ICU stay. Fever upon admission, high CCI, and ICU need were associated with an increased risk of readmission, whereas independent indicators of mortality included high care needs, low BMI, and prolonged hospitalization. [ABSTRACT FROM AUTHOR]

Background: Scopolamine is a widely used antiemetic in anesthetic practice, particularly for postoperative and post-discharge nausea and vomiting. Despite its frequent usage and recognized efficacy, concerns have emerged regarding the potential for increased side effects, particularly in elderly patients. Further research is needed to assess safety and determine age thresholds for adverse events. This study hypothesizes associations between perioperative scopolamine use, worse clinical outcomes, increased pneumonia, delirium, urinary retention, and readmissions. Methods: A large, retrospective cohort study was performed using the TriNetX Analytics Network database on patients undergoing major surgical procedures between Jan 1, 2009, and March 21, 2018, to examine the impact of perioperative scopolamine use on in-hospital adverse events. Patients were divided into age groups and compared to a control group. The primary outcomes assessed were delirium, pneumonia, in-hospital death, new antipsychotic use, readmission, and new onset urinary retention within 7 days post-surgery. 1:1 propensity score matching was performed to reduce bias. Relative risk and risk differences with 95% confidence intervals were estimated. Results: After 1:1 propensity score matching, we identified a total of 403,816 (201,908 pairs) perioperative scopolamine users and nonusers. The cohorts of 20–29, 30–39, 40–49, 50–59, 60–69, and 70 + contained 22,910 (11,455 pairs), 44,170 (22,085 pairs), 58,590 (29,295 pairs), 71,660 (35,830 pairs), 88,386 (44,193 pairs), and 118,100 (59,050 pairs) patients respectively. Across older age cohorts, after propensity score matching, perioperative scopolamine recipients had significantly increased relative risk and risk difference of delirium, pneumonia, in-hospital mortality, new antipsychotic use, readmission, and new-onset urinary retention. Conclusions: In this cohort study, perioperative scopolamine usage was associated with a significantly increased risk of in-hospital adverse events, both within the 70 + age cohort and among the 20–29, 30–39, 40–49, 50–59, and 60–69 age cohorts after major surgery. These findings highlight the need for careful assessment of scopolamine's risks and benefits, especially for patients aged 40 and older. Scopolamine may be most suited for post-discharge nausea and vomiting in ambulatory patients and clinicians should reassess its standard use for postoperative nausea and vomiting, favoring shorter-acting agents with fewer side effects. [ABSTRACT FROM AUTHOR]

Simple Summary: Disparities in outcomes for non-small cell lung cancer (NSCLC) may result from socioeconomic factors and variable healthcare access. We sought to examine the impact of area-level socioeconomic deprivation on access to care and outcomes for early-stage NSCLC in United States Veterans. We studied 9704 patients with clinical stage I NSCLC who underwent surgical treatment in the Veterans Health Administration (VHA) between 2006 and 2016 using a uniquely compiled database. Area-level socioeconomic deprivation was not associated with overall survival or cancer recurrence. However, high levels of socioeconomic deprivation were associated with inadequate adherence to care quality measures and increased risk of postoperative readmission. These results suggest that Veterans with high socioeconomic deprivation experience suboptimal access to quality preoperative and postoperative care for early-stage NSCLC but do not have inferior long-term outcomes following surgery. Future VHA policies should aim to provide more equitable guideline-concordant care and reduce postoperative readmission for early-stage NSCLC. Background: Socioeconomic deprivation has been associated with higher lung cancer risk and mortality in non-Veteran populations. However, the impact of socioeconomic deprivation on outcomes for non-small cell lung cancer (NSCLC) in an integrated and equal-access healthcare system, such as the Veterans Health Administration (VHA), remains unclear. Hence, we investigated the impact of area-level socioeconomic deprivation on access to care and postoperative outcomes for early-stage NSCLC in United States Veterans. Methods: We conducted a retrospective cohort study of patients with clinical stage I NSCLC receiving surgical treatment in the VHA between 1 October 2006 and 30 September 2016. A total of 9704 Veterans were included in the study and assigned an area deprivation index (ADI) score, a measure of socioeconomic deprivation incorporating multiple poverty, education, housing, and employment indicators. We used multivariable analyses to evaluate the relationship between ADI and postoperative outcomes as well as adherence to guideline-concordant care quality measures (QMs) for stage I NSCLC in the preoperative (positron emission tomography [PET] imaging, appropriate smoking management, pulmonary function testing [PFT], and timely surgery [≤12 weeks after diagnosis]) and postoperative periods (appropriate surveillance imaging, smoking management, and oncology referral). Results: Compared to Veterans with low socioeconomic deprivation (ADI ≤ 50), those residing in areas with high socioeconomic deprivation (ADI > 75) were less likely to have timely surgery (multivariable-adjusted odds ratio [aOR] 0.832, 95% confidence interval [CI] 0.732–0.945) and receive PET imaging (aOR 0.592, 95% CI 0.502–0.698) and PFT (aOR 0.816, 95% CI 0.694–0.959) prior to surgery. In the postoperative period, Veterans with high socioeconomic deprivation had an increased risk of 30-day readmission (aOR 1.380, 95% CI 1.103–1.726) and decreased odds of meeting all postoperative care QMs (aOR 0.856, 95% CI 0.750–0.978) compared to those with low socioeconomic deprivation. There was no association between ADI and overall survival (adjusted hazard ratio [aHR] 0.984, 95% CI 0.911–1.062) or cumulative incidence of cancer recurrence (aHR 1.047, 95% CI 0.930–1.179). Conclusions: Our results suggest that Veterans with high socioeconomic deprivation have suboptimal adherence to care QMs for stage I NSCLC yet do not have inferior long-term outcomes after curative-intent resection. Collectively, these findings demonstrate the efficacy of an integrated, equal-access healthcare system in mitigating disparities in lung cancer survival that are frequently present in other populations. Future VHA policies should continue to target increasing adherence to QMs and reducing postoperative readmission for socioeconomically disadvantaged Veterans with early-stage NSCLC. [ABSTRACT FROM AUTHOR]

Highlights: What are the main findings? Chronic disease self-management (CDSM) programs have proven benefits in the management of many chronic diseases, and this study supports new impetus in CHF; CDSM's benefits in improving MACE in CHF remain unclear; CDSM can be delivered as generic or disease-specific programs; the former has been tested widely in CHF, this study suggests possibilities for generic programs What are the implications of the main findings? Generic CDSM programs can be used in CHF; Generic short-form tools derived from gold-standard CDSM can risk-stratify poor and good self-managers. Self-managers with borderline and average abilities require greater understanding when designing randomized trials to further analyze these findings. Background/Objective: Heart failure (HF) is a complex syndrome, with multiple causes. Numerous pathophysiological pathways are activated. Comprehensive and guideline-derived care is complex. A multidisciplinary approach is required. The current guidelines report little evidence for chronic disease self-management (CDSM) programs for reducing readmission and major adverse cardiovascular events (MACE). CDSM programs can be complex and are not user-friendly in clinical settings, particularly for vulnerable patients. The aim of this study was to investigate whether a simplified one-page CDSM tool, the SCReening in Heart Failure (SCRinHF), is comparable to a comprehensive Flinders Program of Chronic Disease Management, specifically in triaging self-management capabilities and in predicting readmission and MACE. Methods:SELFMAN-HF is a prospective, observational study based on community cardiology. Eligible patients, consecutively recruited, had HF with left ventricular ejection fraction <40% and were placed on sodium–glucose co-transporter-2 inhibitors (SGLT2-i) within 3 months of recruitment. SGLT2-i is the newest of the four HF treatment pillars; self-management skills are assessed at this juncture. CDSM was assessed and scored independently via the long-form (LF) and short-form (SF) tools, and concordance between forms was estimated. The primary endpoint is the 80% concordance across the two CDSM scales for predicting hospital readmission and MACE. Results: Of the 117 patients, aged 66.8 years (±SD 13.5), 88 (75%) were male. The direct comparisons for SF versus LF patient scores are as follows: "good self-managers", 13 vs. 30 patients (11.1% vs. 25.6%); "average", 46 vs. 21 patients (39.3% vs. 17.9%), "borderline", 20 vs. 31 patients (17.1% vs. 26.5%), and "poor self-managers" (vulnerable), 38 vs. 35 patients (32.5% vs. 29.9%). These findings underscore the possibility of SF tools in picking up patients whose scores infer poor self-management capabilities. This concordance of the SF with the LF scores for patients who have poor self-management capabilities (38 vs. 35 patients p = 0.01), alongside readmission (31/38 vs. 31/35 p = 0.01) or readmission risk for poor self-managers versus good self-managers (31/38 vs. 5/13 p = 0.01), validates the simplification of the CDSM tools for the vulnerable population with HF. Similarly, when concurrent and predictive validity was tested on 52 patients, the results were 39 (75%) for poor self-managers and 14 (27%) for good self-managers in both groups, who demonstrated significant correlations between SF and LF scores. Conclusions: Simplifying self-management scoring with an SF tool to improve clinical translation is justifiable, particularly for vulnerable populations. Poor self-management capabilities and readmission risk for poor self-managers can be significantly predicted, and trends for good self-managers are observed. However, correlations of SF to LF scores across an HF cohort for self-management abilities and MACE are more complex. Translation to patients of all skill levels requires further research. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions. Methods: Retrospective cohort study of all hospitalizations for fluid overload in adults with diabetes and ESKD on dialysis in SingHealth hospitals between 2018 and 2021. Fluid overload was defined by discharge codes for fluid overload, heart failure, pulmonary edema, and generalized edema. Multivariable Cox regression analysis using the Prentice, Williams and Peterson Total Time model was performed for the outcomes of readmissions for fluid overload within 30 days and 90 days of discharge. Results: Among 3,234 hospitalizations for fluid overload, readmission for fluid overload within 30 days and 90 days occurred in 585 (18.1%) and 967 (29.9%) hospitalizations, respectively. Ischemic heart disease, peripheral vascular disease, and lower hemoglobin level were independently associated with readmissions for fluid overload within 30 and 90 days. Additionally, heart failure, hemodialysis (compared to peritoneal dialysis), and lack of statin at discharge were associated with increased 90-day readmission risk. Conclusion: Modifiable (hemoglobin level, statin use) and non-modifiable factors (ischemic heart disease, peripheral vascular disease, and heart failure) influenced the risk of readmission for fluid overload. These results may guide risk stratification and inform targeted interventions to reduce avoidable, unplanned readmissions for recurrent fluid overload among individuals with diabetes and ESKD. [ABSTRACT FROM AUTHOR]

Introduction: Malignancy-related ascites (MRA) is a common serious complication of many advanced malignant tumors with high morbidity and mortality. The high hospital expenditures induced by unplanned readmission in patients with MRA have become an urgent issue to the public. We aimed to overall assess the unplanned early readmission rate of patients with MRA and explore the potential risk factors for such readmission. Methods: A retrospective cohort study based on 2018 Nationwide Readmissions Database was performed and patients with MRA were recruited into the analysis. The primary outcome was unplanned 30-day readmission rate and inpatient outcomes. The multivariate logistic regression analysis was performed to evaluate the potential risk factors for such early readmission. Results: Data obtained from 32,457 patients with MRA were analyzed, and of these 7,799 individuals (24.03%) were unplanned readmitted within 30-day follow-up. The mortality rate in the readmitted population was 15.15%. Patients at younger age were at a higher risk of readmission. The morbidities including hypertension (OR=1.117, 95%CI: 1.054-1.184), hyperlipemia (OR=1.075, 95%CI: 1.009-1.146) and diabetes (OR=1.118, 95%CI: 1.053-1.188), gastrointestinal malignancies and peritoneal procedure significantly increased the risk of 30-day readmission in patients with MRA. Discussion: More than one in five patients with MRA was unplanned readmitted within 30-day follow-up. The above risk factors should be timely intervened and the corresponding medical care should be strengthened in patients with MRA to lessen the unplanned readmission and improve the readmission outcomes. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the potential association between the treatment with Xinfeng Capsule (XFC) and the risk of readmission among patients with rheumatoid arthritis (RA). Methods: Through a retrospective approach, data were collected from all hospitalized patients diagnosed with RA at the First Affiliated Hospital of Anhui University of Chinese Medicine between 2013 and 2021. To mitigate selection bias and confounding factors, patients were stratified into an XFC group and a Non-XFC (Non-XFC) group based on their treatment status using propensity score matching with a 1:2 ratio. Variables such as age, gender, and baseline medications were adjusted. Subsequently, the Cox proportional hazards model was employed to calculate the hazard ratio (HR) for readmission among RA patients, while Kaplan-Meier curves were utilized to depict the incidence of readmission. Results: A total of 9987 RA patients were included in this study. Following rigorous inclusion/exclusion criteria and propensity score matching, the XFC group comprised 2036 patients, while the Non-XFC group contained 4072 patients. The Cox proportional hazards model analysis revealed that XFC acted as a protective factor, significantly reducing the risk of readmission among RA patients. Further examination of Kaplan-Meier curves demonstrated that XFC use not only effectively lowered the frequency of readmissions but also exhibited a more pronounced effect in diminishing the risk of readmission with extended usage durations (beyond 12 months). Additionally, association rule analysis underscored the strong link between XFC and freedom from readmission, as well as the robust correlation between XFC usage and significant improvements in multiple laboratory indicators, including C3, C4, CRP, ESR, and others. Conclusion: This study underscores a robust and long-term association between XFC usage and lower readmission rates among RA patients. As a protective factor against readmission risk in these patients, the clinical value of XFC merits further promotion and investigation. [ABSTRACT FROM AUTHOR]

Introduction: We investigated the factors associated with readmission in patients with congestive heart failure (HF) receiving long-term administration of tolvaptan (TLV) to support treatment decisions for HF. Methods: This retrospective cohort study included 181 patients with congestive HF who received long-term administration of TLV. Long-term administration of TLV was defined as the administration of TLV for 60 days or longer. The outcome was a readmission event for worsening HF within 1 year after discharge. Significant factors associated with readmission were selected using multivariate analysis. To compare the time to readmission using significant factors extracted in a multivariate analysis, readmission curves were constructed using the Kaplan--Meier method and analysed using the log-rank test. Results: The median age was 78 years (range, 38-96 years), 117 patients (64.6%) were males, and 77 patients (42.5%) had a hospitalisation history of HF. Readmission for worsening HF within 1 year after long-term TLV treatment occurred in 62 patients (34.3%). In the multivariate analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m² (odds ratio, 3.22; 95% confidence interval, 1.661-6.249; P = 0.001) was an independent significant factor. When eGFR at discharge was divided into two groups (eGFR < 30 vs. eGFR ≥ 30), readmission rates within 1 year were 53.3% vs. 25.4%, respectively (P = 0.001). Conclusion: We revealed that eGFR was strongly associated with readmission in patients with HF who received long-term administration of TLV. Furthermore, we showed that eGFR is an important indicator in guiding treatment of HF in patients receiving TLV. [ABSTRACT FROM AUTHOR]

Ziyan Dong, Wen Xie, Liuqing Yang, Yue Zhang, Jie Li School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of ChinaCorrespondence: Jie Li, School of Nursing, Tongji Medical College, 13 hangkong Road, Qiaokou District, Wuhan, Hubei Province, 430030, People’s Republic of China, Tel +86-189-7109-7091, Email Lijie@hust.edu.cnPurpose: Readmission within a period time of discharge is common and costly. Diabetic patients are at risk of readmission because of comorbidities and complications. It is crucial to monitor patients with diabetes with risk factors for readmission and provide them with target suggestions. We aim to develop a nomogram to predict the risk of readmission within 90 days of discharge in diabetic patients.Patients and Methods: This is a prospective observational survey. A total of 784 adult patients with diabetes recruited in two tertiary hospitals in central China were randomly assigned to a training set or a validation set at a ratio of 7:3. Depression, anxiety, self-care, physical activity, and sedentary behavior were assessed during hospitalization. A 90-day follow-up was conducted after discharge. Multivariate logistic regression was employed to develop a nomogram, which was validated with the use of a validation set. The AUC, calibration plot, and clinical decision curve were used to assess the discrimination, calibration, and clinical usefulness of the nomogram, respectively.Results: In this study, the 90-day readmission rate in our study population was 18.6%. Predictors in the final nomogram were previous admissions within 1 year of the index admission, self-care scores, anxiety scores, physical activity, and complicating with lower extremity vasculopathy. The AUC values of the predictive model and the validation set were 0.905 (95% CI=0.874– 0.936) and 0.882 (95% CI=0.816– 0.947). Hosmer–Lemeshow test values were p = 0.604 and p = 0.308 (both > 0.05). Calibration curves showed significant agreement between the nomogram model and actual observations. Decision curve analysis indicated that the nomogram improved the clinical net benefit within a probability threshold of 0.02– 0.96.Conclusion: The nomogram constructed in this study was a convenient tool to evaluate the risk of 90-day readmission in patients with diabetes and contributed to clinicians screening the high-risk populations.Keywords: readmission, rehospitalization, diabetes, nomogram, prediction model, diabetes mellitus

Abstract Background Frequent exacerbations of bronchiectasis lead to poor quality of life, impaired lung function, and higher mortality rates. This study aims to evaluate the risk factors associated with readmission within one year due to acute exacerbation of bronchiectasis (AEB). Methods A retrospective cohort study was performed on 260 patients with bronchiectasis who were hospitalized in the respiratory and critical care department of a tertiary hospital in China. Univariate and multivariate Cox analyses were used to evaluate the risk factors for readmission within one year. Results Readmission within one year was found in 44.6% of 260 patients hospitalized with acute exacerbation of bronchiectasis. The risk factors associated with readmission included age over 65 years (HR = 3.66; 95% CI: 2.30 to 5.85), BMI

Background: Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients. Methods: This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented. Results: Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension). Conclusion: The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge.

Li Li, Qinsheng Feng, Chunsong Yang Department of Respiratory and Critical Care Medicine, Baise People’s Hospital, Baise, Guangxi, 533099, People’s Republic of ChinaCorrespondence: Li Li, Department of Respiratory and Critical Care Medicine, Baise People’s Hospital, No. 8, Chengxiang Road, Youjiang District, Baise, Guangxi, 533099, People’s Republic of China, Tel +86-0776-2851142, Email llidoctorICU@outlook.comPurpose: To explore the association of D-dimer-to-albumin ratio (DAR) with hospital readmission within one year in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).Patients and Methods: From January 2019 to October 2022, 509 patients with COPD were enrolled in Baise People’s Hospital for this retrospective cohort study. Baseline data and blood samples were collected, and patients were followed up for one year after inclusion. The AECOPD hospital readmission within one year was the outcome. Receiver operating characteristics (ROC) curves were conducted to determine the prognostic performance of DAR for predicting readmission within one year. The relationships between DAR, neutrophil-to-lymphocyte ratio (NLR), and AECOPD hospital readmission were conducted using univariate and multivariate logistic regression models, with odds ratios (ORs) and 95% confidence intervals (CIs). The relationship was further explored in different modified Medical Research Council (mMRC), COPD assessment test (CAT), COPD course, pneumonia, glucocorticoid, antibiotic subgroups.Results: Totally, 117 (22.99%) COPD patients were hospital readmission due to AECOPD. The area under the curve (AUC) for the DAR was 0.726. DAR ≥ 2.21 (OR=1.80, 95% CI: 1.05– 3.17) was associated with elevated odds of AECOPD hospital readmission within one year. DAR ≥ 2.21 was related to increased odds of AECOPD hospital readmission in patients of those mMRC ≥ 2, CAT > 20, COPD course < 10 years, and pneumonia. NLR ≥ 3.69 was associated with higher odds of AECOPD hospital readmission in patients of those mMRC ≥ 2 and COPD course ≥ 10 years.Conclusion: In patients with AECOPD, DAR showed a better predictive value in predicting the risk of hospital readmission in patients with AECOPD within one year. The findings of our study might help identify patients with a high risk of readmission within one year and provide timely treatment to prevent the reoccurrence of AECOPD.Keywords: acute exacerbation, chronic obstructive pulmonary disease, readmission, D-dimer to albumin ratio

Background: The incidence of primary reverse total shoulder arthroplasty (rTSA) and the prevalence of obesity have increased in the United States. Despite this, the literature assessing the effect of morbid obesity (body mass index≥40 kg/m2) on perioperative surgical outcomes remains inconsistent. Methods: A retrospective review of consecutive elective primary rTSA cases from January 2016 through September 2023 at a single tertiary referral center was performed. All cases involved a short-stem humeral component and screw-in glenoid baseplate from the same implant manufacturer. Surgical and patient demographic data were collected. Morbidly obese patients were propensity matched at least 1:1 with non-morbidly obese patients based on age, gender, modified 5-item frailty index score, adjusted Charlson comorbidity index score, and 12-month preoperative emergency department (ED) visit. Regression analysis was utilized to assess the relationship between morbid obesity and operative time, length of stay, intraoperative total blood volume loss, surgical postoperative complications, in-hospital medical complications, disposition, and 90-day ED return and readmission. Results: There were a total of 175 short-stem rTSA cases performed with a median age of 71 years (interquartile range: 66, 76), of which 19 (10.9%) had a body mass index ≥40 kg/m2. These 19 patients were propensity score matched to 41 non-morbidly obese patients (9 at 1:3, 4 at 1:2, and 6 at 1:1). There were no significant differences between the groups with regard to intraoperative total blood volume loss, operative time, need for transfusion, hospital length of stay, discharge disposition, prevalence for 90-day return to ED, or unplanned 90-day readmission. Conclusion: Morbid obesity should not be considered an absolute contraindication for elective rTSA, particularly in patients who have undergone appropriate preoperative medical clearance.

BackgroundHospital readmission trends for persons with human immunodeficiency virus (PWH) in North America in the context of policy changes, improved antiretroviral therapy (ART), and aging are not well-known. We examined readmissions during 2005-2018 among adult PWH in NA-ACCORD.MethodsLinear risk regression estimated calendar trends in 30-day readmissions, adjusted for demographics, CD4 count, AIDS history, virologic suppression (

IntroductionHeart failure (HF) is a frequent cause of readmissions. Despite caring for underresourced patients and dependence on government funding, safety net hospitals frequently incur penalties for failing to meet pay-for-performance readmission metrics. Limited research exists on the causes of HF readmissions in safety net hospitals. Therefore, we sought to investigate predictors of 30-day all-cause readmission in HF patients in the safety net setting.MethodsWe performed a retrospective chart review of patients admitted for HF from October 2018 to April 2019. We extracted data on demographics and medical comorbidities and performed patient-specific review of social determinants and mental health in 4 domains: race/ethnicity, housing status, substance use, and mental illness. Multivariable Poisson regression modeling was employed to evaluate associations with 30-day all-cause readmission.ResultsThe study population included 290 patients, among whom the mean age was 59 years and 71% (n = 207) were male; 42% (120) were Black/African American (AA), 22% (64) were Hispanic/Latino, and 96% (278) had public insurance; 28% (79) were not housed, 19% (56) had a diagnosis of mental illness, and active substance use was common. The 30-day readmission rate was 25.5% (n = 88). Factors that were associated with increased risk of readmission included self-identifying as Black/AA (relative risk 2.28, 95% confidence interval 1.00-5.20) or Hispanic/Latino (2.53, 1.07-6.00), experiencing homelessness (2.07, 1.21-3.56), living in a shelter (3.20, 1.27-8.02), or intravenous drug use (IVDU) (2.00, 1.08-3.70).ConclusionRace/ethnicity, housing status, and substance use were associated with increased risk of 30-day all-cause readmission in HF patients in a safety net hospital. In contrast to prior studies, medical comorbidities were not associated with increased risk of readmission.

Abstract Aims There is a lack of tools for accurately identifying the risk of readmission for heart failure in elderly patients with arrhythmia. The aim of this study was to establish and compare the performance of the LACE [length of stay (‘L’), acute (emergent) admission (‘A’), Charlson comorbidity index (‘C’) and visits to the emergency department during the previous 6 months (‘E’)] index and machine learning in predicting 1 year readmission for heart failure in elderly patients with arrhythmia. Methods Elderly patients with arrhythmia who were hospitalized at Sichuan Provincial People's Hospital between 1 June 2018 and 31 May 2020 were enrolled. The LACE index was calculated for each patient, and the area under the receiver operating characteristic curve (AUROC) was calculated. Six machine learning algorithms, combined with three variable selection methods and clinically relevant features available at the time of hospital discharge, were used to develop machine learning models. AUROC and area under the precision–recall curve (AUPRC) were used to assess discrimination. Shapley additive explanations (SHAP) analysis was used to explain the contributions of the features. Results A total of 523 patients were enrolled, and 108 patients experienced 1 year hospital readmission for heart failure. The AUROC of the LACE index was 0.5886. The complete machine learning model had the best predictive performance, with an AUROC of 0.7571 and an AUPRC of 0.4096. The most important predictors for 1 year readmission were educational level, total triiodothyronine (TT3), aspartate aminotransferase/alanine aminotransferase (AST/ALT), number of medications (NOM) and triglyceride (TG) level. Conclusions Compared with the LACE index, the machine learning model can accurately identify the risk of 1 year readmission for heart failure in elderly patients with arrhythmia.

Abstract Background To assess the effect of pneumonia on the risk of mortality and other clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods PubMed, EMBASE and Scopus were screened for observational cohort and case-control studies that reported outcomes in AECOPD patients with and without pneumonia. Pooled effect sizes were reported as relative risks (RR) or hazard ratio (HR) for categorical outcomes and as weighted mean difference (WMD) for continuous outcomes. The primary outcome was mortality. Secondary outcomes were risk of admission to intensive care unit (ICU), need for assisted ventilation and readmission as well as duration of stay at the hospital. The certainty of the evidence was assessed using the GRADE approach. Results Thirteen studies were included. AECOPD patients with pneumonia had significantly higher risk of in-hospital mortality (RR 2.29, 95% CI: 1.40, 3.73), mortality at 1 month (RR 1.84, 95% CI: 1.09, 3.13), and 1 year or more of follow-up (HR 2.30, 95% CI: 1.15, 4.61) compared to AECOPD patients without pneumonia. Pneumonia was associated with significantly higher risk of admission to ICU (RR 2.79, 95% CI: 1.47, 5.28), need for assisted ventilation (RR 2.02, 95% CI: 1.52, 2.67), and longer hospital stay (in days) (WMD 3.31, 95% CI: 2.33, 4.29). The risk of readmission was comparable in the two groups of patients (RR 1.07, 95% CI: 0.97, 1.19). The overall quality of evidence for the outcomes was judged to be “Low”. Conclusion Pneumonia during acute exacerbation of COPD may lead to increases in both short-term and long-term mortality as well as increased hospital stay, need for ventilatory support and admission to ICU. Our findings suggest the need for close monitoring, early intervention, and long-term follow-up, to improve the outcomes in AECOPD patients with concurrent pneumonia.

Abstract The burden of heart failure increases over time and is a leading cause of unplanned readmissions worldwide. In addition, its impact has doubled in countries with limited health resources, including Ethiopia. Identifying and preventing the possible contributing factors is crucial to reducing unplanned hospital readmissions and improving clinical outcomes. The study aimed to assess the incidence and predictors of 30-day unplanned readmission among heart failure patients at selected South Wollo general hospitals in 2022. A hospital-based retrospective cohort study design was employed from January 1, 2016, to December 30, 2020. The data was collected from 572 randomly selected medical records using data extraction checklists. Data were entered in Epi-Data version 4.6 and analyzed with Stata version 17. The Kaplan–Meier and log-rank tests were used to estimate and compare the survival failure time. A Cox proportional hazard analysis was used to identify the predictors of readmission. The statistical significance level was declared at a p-value 65 years) (AHR: 3.172, 95% CI:.21, 4.55, P = 0.001), rural in residency (AHR: 2.47, 95%CI: 1.44, 4.24, P = 0.001), Asthma or Chronic Obstructive Pulmonary Disease (AHR: 1.62, 95% CI: 1.11, 2.35, P = 0.012), HIV/AIDS (AHR: 1.84, 95%CI: 1.24, 2.75, P = 0.003), Haemoglobin level 8–10.9 g/dL (AHR: 6.20, 95% CI: 3.74, 10.28, P = 0.001), and Mean platelet volume > 9.1 fl (AHR: 2.08, 95% CI: 1.27, 3.40, P = 0.004) were identified as independent predictors of unplanned hospital readmission. The incidence of unplanned hospital readmission was relatively high among heart failure patients. Elderly patients, rural residency, comorbidity, a higher mean platelet volume, and a low hemoglobin level were independent predictors of readmission. Working on these factors will help reduce the hazards of unplanned hospital readmission.

Abstract Background Robotic-assisted technologies have been developed to increase surgical precision and reduce surgical variability in total knee arthroplasty (TKA). Several different robotic systems have been introduced in the last decade for TKA. The DePuy Synthes VELYS™ Robotic-Assisted Solution (VRAS) is an imageless system designed to eliminate the need for preoperative CT scans and is one of the latest entrants in the rapidly evolving field of robotic technology in TKA. This study compared the clinical and economic outcomes associated with VRAS and other robotic-assisted technologies for primary TKA. Methods A retrospective cohort study using the Premier Healthcare Database included patients who underwent primary TKA with VRAS or other robotic-assisted technologies from January 1, 2022, to April 30, 2023. The primary outcome for the study was hospital follow-up visits (revisits) within 90 days post-TKA. Secondary outcomes included readmission and revision rates within 90 days post-TKA, operating room time, length of stay, discharge status and hospital costs. Cohorts were balanced using propensity score fine stratification, and generalized linear models were constructed to evaluate outcomes. Results This study included 827 VRAS TKA patients and 16,428 TKA patients treated with other robotic-assisted technologies. The 90-day all-cause and knee-related revisit rates were significantly lower for VRAS than for other robotic-assisted technologies (all-cause 13.9% vs. 22.8% and knee-related 2.8% vs. 5.4%, respectively; p value

Abstract Background Readmissions in psychiatric inpatient care may reflect problems in the provision of care, but the underlying factors are not well known. We examined the associations of patient characteristics (sociodemographic factors, diagnoses), treatment (duration, previous episodes, neuromodulation) and ward overload with psychiatric inpatient readmissions and multiple readmissions in Finland. Methods We used a routinely collected data pool from one hospital district and followed all 2052 hospitalizations that started in 2018. The outcomes were readmission within 30 days and one year, and among those with readmission, the number of readmissions. Results Of the patients, 11% had readmission within 30 days and 33% had readmission within one year. Women, those with previous hospitalizations, those with an ICD-10 diagnosis from the ‘behavioural syndromes associated with physiological disturbances and physical factors / disorders of adult personality and behaviour’ group, those with a diagnosis from the ‘neurotic, stress-related and somatoform disorders’ group, those with psychotic disorders, and those who received neuromodulation treatment were more likely to have readmissions. Having a diagnosis of ‘disorders of psychological development’ or ‘behavioural and emotional disorders with onset usually occurring in childhood and adolescence’ was associated with a lower likelihood of readmission. The duration of treatment and ward overload during the index period were not associated with readmission. Conclusions The findings of this study suggest possible risk factors for readmission and can be used to plan psychiatric care. To some degree, the risk factors varied between different readmission types. It is important to examine whether there are unmet treatment needs in psychiatric inpatient care for children and adolescents.

Objectives: Comorbidities that impair wound healing, increase infection risk, and compromise tissue viability influence rates of hospital readmission after autologous reconstruction and implant-based reconstruction. This study aimed to evaluate patient factors that increase risk for 30-day hospital readmission after autologous reconstruction and implant-based reconstruction and identify differences in the comorbidities that affect readmission risk after each method. Methods: Patients from 2005 to 2021 were selected by autologous reconstruction and implant-based reconstruction current procedural terminology codes from the American College of Surgeons National Surgical Quality Improvement Program database. A multivariable regression model identified the significant predictors of unplanned readmission. Results: Comorbidities that increase risk for readmission after autologous reconstruction but not implant-based reconstruction include dialysis (OR 3.87, p = 0.042) and malnutrition (OR 3.20, p = 0.003). Risk factors for readmission after implant-based reconstruction but not autologous reconstruction include bleeding disorder (OR 2.62, p < 0.0001), previous infection (OR 1.49, p = 0.045), recent sepsis (OR 2.16 p = 0.0003), anemia (OR 1.13, p = 0.0018), and hypoalbuminemia (OR 1.35, p = 0.0213). Predictors of unplanned readmission after both methods include chronic obstructive pulmonary disorder, obesity, inpatient status prior to procedure, Black or White race, chronic steroid use, smoking, diabetes, and hypertension. Conclusions: These findings may be used to individualize preoperative discussions and help guide optimization of risk factors. In addition, while autologous reconstruction and implant-based reconstruction are often combined into one category for discussion of factors that increase complication risk, our study suggests that the types of reconstruction differ with regard to the comorbidities that increase risk for hospital readmission.

Background: The impact of socioeconomic distress on readmission rates following cardiac surgery has not been studied. We hypothesized that patients living in distressed communities would have a higher 30-day readmission rate after cardiac surgery compared to those living in less distressed communities. Methods: Patients undergoing isolated coronary artery bypass grafting (CABG) between 2016 and 2023 within a regional collaborative were identified. The Distressed Communities Index (DCI) and Area Deprivation Index (ADI) were used to measure socioeconomic distress. Two logistic regression models were performed to evaluate 30-day readmission rates: one incorporating ADI and the other including DCI. Models were adjusted for the Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM) score, postoperative complications, length of stay (LOS), year of surgery, and discharge disposition. Results: A total of 16,369 patients were included, of whom 10% were readmitted within 30 days of discharge. Readmitted patients were more likely to be female (32% vs 23.3%) and to develop postoperative complications (47% vs 35%) and less likely to be discharged to home (70.6% vs 83.5%; P

Objective: The need for reinstitution of intensive care unit (ICU) care (“recidivism”) in post-cardiac surgery patients is associated with increased morbidity, mortality, resource use, and healthcare costs. Recidivism is propounded as a quality indicator of ICU care. There is a paucity of studies from India regarding cardiac surgical ICU readmissions, their outcomes, and risk factors. Methods: Nested case-control study including 1,711 consecutive adult patients who underwent cardiac surgery over a two-year period at a tertiary care institute. The patients were grouped into recidival (R) and control (C) groups. The reasons for readmission, outcomes, and predictive risk factors were analyzed. Results: Fifty-four of 1,711 (3.1%) patients were readmitted to ICU, main reasons being cardiac arrhythmias (24, 41%), pericardial effusion (9, 15.2%), and infection (8, 13.5%). Readmission was significantly higher for valvular interventions (39 patients, 24.3%, mitral valve 25 patients) than coronary artery bypass grafting (13, 10.6%), P value 0.003*. On multivariate analysis, EuroSCORE 2 (>5), age, surgical reexploration, postoperative pulmonary complications, and infections were independently associated with a need for ICU readmission. The mortality rate among the readmitted patients was 7.4% compared to 1.4% overall mortality. The mean total postoperative length of stay was significantly longer for recidival patients (17.6 ± 14 days vs 7.6 ± 2.4 days; P < 0.0001). Conclusions: Recidivism is associated with longer hospital stay, suboptimal outcomes as well higher risk of mortality. Postoperative cardiac dysrhythmia was the most common cause of recidivism in our cohort. Early identification of patients at risk for recidivism and timely management of cardiopulmonary complications can translate to better outcomes.

Introduction: Mortality benefit of digoxin prescription in patients suffering from heart failure has been questioned many time. We evaluated these effects among admitted symptomatic heart failure patients. Methods: We retrospectively divided our patients into two groups: group A (n=205) were digoxin prescribed, and group B (n=96) were digoxin naïve patients. Both groups’ medical records were gathered for one year, and the study endpoints were compared between the two groups. Results: The mean age was 62.3±12.1 years and 54.8 % were male. All-cause mortality and readmission occurred in 26.7% and 31.7% of individuals, respectively, without significant differences between the two groups. However, in subgroup analysis, there was a significant relationship between in-hospital mortality and the presence of cardiovascular risk factors. Conclusion: Digoxin might increase in-hospital mortality in patients with underlying cardiovascular risk factors.

Aihaidan Abudouwayiti, Sureya Yisimayili, Ruzeguli Tuersun, Salamaiti Aimaier, Didaer Yisha, Xing Yan Zhang, Ying-Ying Zheng,&ast; Ailiman Mahemuti&ast; The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying-Ying Zheng; Ailiman Mahemuti, Cardiovascular Department of The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, People’s Republic of China, Tel +86-15214804944 ; +86-13639970300, Email zhengying527@163.com; xinjiangailiman@163.comBackground: The role of high-density lipoprotein cholesterol (HDL-C) in heart failure (HF) outcomes is contentious. We aimed to assess HDL-C’s prognostic value in HF patients.Methods: In this retrospective cohort study (2012– 2022) at the First Affiliated Hospital of Xinjiang Medical University, we analyzed 4442 patients, categorized by HDL-C quartiles. We applied the Cox proportional hazards model to assess survival and report hazard ratios (HR) with 95% confidence intervals (CI).Results: Over a decade, we recorded 1354 fatalities (42.3%) and 820 readmissions. The third HDL-C quartile (0.93– 1.14 mmol/L) showed the lowest mortality rates, with reduced risks in the second and third quartiles compared to the first (Q2 HR=0.809, 95% CI 0.590– 1.109; Q3 HR=0.794, 95% CI 0.564– 1.118). The fourth quartile presented a lower mortality risk compared to the first (Q4 HR=0.887, 95% CI 0.693– 1.134). A significant correlation existed between HDL-C levels and cardiovascular risk (HR=0.85, 95% CI 0.75– 0.96, p< 0.01).Conclusion: HDL-C levels exhibit a complex association with mortality in HF, indicating the importance of HDL-C in HF prognosis and the need for tailored management strategies.Keywords: high-density lipoprotein cholesterol, heart failure, death, readmission, cardiovascular disease

Abstract Background Historically, ankle fractures have been treated with open reduction and internal fixation (ORIF) procedures, which are considered safe and effective. Patient characteristics may contribute to postoperative difficulties thereby increasing risk of hospital readmission. The objective of this study was to determine the frequency of and reasons for 30-day readmission and postoperative complications following ORIF for ankle fractures. Methods A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database from 2015 to 2021 identified patients undergoing ORIF for ankle fractures. Patient demographics, complication incidence, and reasons for unplanned hospital readmission were collected. Multivariable analyses identified patient risk factors for any adverse event (AAE) and readmission within 30-days of surgery. Results The 29,905 patients queried who underwent ORIF procedures for ankle fractures between 2015 and 2021 were 49.6 ± 18.40 years of age, 30.9 ± 7.10 kg/m2, and 40.81% male. Of this cohort, 981 (3.30%) experienced 30-day postoperative adverse events, with surgical site infections (SSI; 1.25%) the most common. Unplanned readmission was observed in 2.08% of patients after a mean of 14.64 days. Surgical site related readmissions were 20.55% (n = 128) of reported readmissions with the most common being superficial incisional SSI. Notable risk factors for adverse events included ASA class (OR = 1.579, P

Abstract Aims The predictive value of the lactate/albumin ratio (LAR) in mortality is established in various conditions, yet its relevance to 3‐month readmission risk in Chinese adults with heart failure (HF) remains unclear. Method and results Analysing data from 957 patients with HF at Zigong Fourth People's Hospital, Sichuan, China (December 2016 to June 2019), we assessed baseline characteristics, vital signs, comorbidities, and prescriptions. LAR demonstrated a linear correlation with 3‐month readmission risk (HR = 1.60, 95% CI: 1.19–2.16). Tertile 3 (≥−0.48) exhibited higher risk than tertile 1 (

Abstract Background The efficacy of dapagliflozin in patients with acute heart failure remains unclear. Objective To investigate the impact of dapagliflozin (DAPA) on loop diuretics use and 90-day readmission in patients with acute heart failure. Methods In a retrospective cohort study, patients diagnosed with acute heart failure or chronic heart failure with acute exacerbation admitted to Fuyang People’s Hospital from January 2021 to April 2023, this study used DAPA (at a dose of 10 mg once daily) in combination with standard treatment. The patients were divided into DAPA group and DAPA-Free group based on whether they used DAPA in acute heart failure. To minimize the influence of confounding factors and ensure comparability between groups, we used propensity score matching (PSM). Results A total of 399 patients were included, with 206 patients (51.63%) in the DAPA group and 193 patients (48.37%) in the DAPA-Free group. PSM produced 160 pairs. After PSM, there were no statistically significant differences between the DAPA and DAPA-Free groups in terms of readmission of all causes (16.88% vs. 18.12%, OR 0.9141, 95% CI 0.5385–1.552, log rank P = 0.739) or readmission for heart failure (11.88% vs. 15.0%, OR 0.9077, 95% CI 0.4441–1.469, log rank P = 0.484) after 90-day follow-up. Patients in the DAPA group had a lower mean daily dose of intravenous loop diuretics compared to the DAPA-Free group (20 mg/d vs. 30.00 mg/d, P

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease. Objective This study aimed to investigate the self-management ability of patients with MASLD, analyse related factors that may affect self-management ability and evaluate the impact of this ability on readmission. Methods The study recruited patients with MASLD admitted to the Department of Infectious Diseases, First Affiliated Hospital of Wenzhou Medical University, between February and October 2021 using the random sampling method. The MASLD diagnosis was based on the guidelines for the prevention and treatment of MASLD. An analysis of patients’ self-management ability was conducted using the self-management ability scale for patients with MASLD. Multiple linear regression analysis was used to analyse the factors influencing this self-management ability, and the readmission rate within 1 year was tracked. The patients were rediagnosed as having MASLD upon readmission to the hospital. Results A total of 241 baseline data items and self-management scale scores for patients with MASLD were collected and investigated. In our study, the normal score range for the self-management scale was 31–155 points, and the self-management scale scores for patients with MASLD was 91.24 ± 16.98, with a low level of self-management accounting for 52.7% and a medium level accounting for 44.8%. The results of the multiple linear regression analysis revealed that marital status, smoking history, fatty liver severity and education were the main factors affecting self-management ability (P

Objective To analyze the relationship between inflammatory reaction and the short-term readmission of hospitalized patients with chronic obstructive pulmonary disease （COPD） complicated with respiratory failure. Methods Ninety-one hospitalized patients with COPD complicated with respiratory failure were included in this prospective cohort study. They were divided into the occurrence group （n =17） and the non-occurrence group （n =74） according to the occurrence of complications during hospitalization. They were also divided into the readmission group （n =18） and the non-readmission group （n =73） according to the 30-d readmission situation. Another 91 patients with COPD alone were assigned into the control group. The pre-treatment inflammation indicators （white blood cell （WBC）， C-reactive protein （CRP）， tumor necrosis factor-α （TNF-α）） were compared between patients with COPD alone and COPD complicated with respiratory failure and different prognosis. The risk factors of 30-d readmission of COPD complicated with respiratory failure were identified by multivariate binary Logistic regression analysis. The receiver operating characteristic （ROC） curve was delineated to analyze the diagnostic values of these risk factors for the short-term readmission of COPD patients complicated with respiratory failure. Results After treatment， the levels of WBC， CRP， and TNF-α in COPD patients with respiratory failure and simple COPD were significantly lower than those before treatment （all P <0.05）. The levels of WBC， CRP and TNF-α in patients with COPD complicated with respiratory failure before treatment were significantly higher than those in patients with COPD alone （all P <0.05）. The levels of WBC， CRP and TNF-α in COPD patients complicated with type Ⅱ respiratory failure before treatment were significantly higher than those in patients complicated with type Ⅰ respiratory failure （all P <0.05）. The levels of CRP and TNF-α in the occurrence group before treatment were significantly higher than those in the non-occurrence group （both P <0.05）. The levels of CRP and TNF-α in the readmission group before treatment were significantly higher than those in the non-readmission group （both P <0.05）. Multivariate binary logistic regression analysis showed that there was no significant correlation between CRP and TNF-α levels and the 30-d readmission of COPD patients after adjusting for confounding factors （both P >0.05）. However， regardless of the adjustment for confounding factors， CRP and TNF-α levels were significant factors affecting the 30-d readmission of COPD patients with respiratory failure （both P <0.05）. The area under the ROC curve （AUC） of CRP， TNF-α and two combined before treatment for predicting 30-d readmission of COPD patients complicated with respiratory failure all exceeded 0.70， which had certain predictive value. Conclusions CRP and TNF-α yield high efficiency in predicting the short-term readmission of COPD patients complicated with respiratory failure. Treatment plans can be formulated according to CRP and TNF-α levels to reduce the risk of readmission.

Background: The geriatric nutritional risk index (GNRI) is a valuable tool that may predict the prognosis of elderly patients with heart failure (HF). Malnutrition and low GNRI scores have been associated with a higher risk of hospitalization and mortality. This study aimed to investigate the association between GNRI and 6‐month readmission for HF in elderly Chinese patients. Materials and Methods: The study utilized data from hospitalized HF patients by combining electronic medical records from the PhysioNet restricted health data database with external outcome data. In our study, we used the GNRI as the independent variable and assessed its association with the risk of readmission within 6 months. The main analytical methods were multivariable Cox regression, stratified analysis with interaction, threshold effect analysis, and Kaplan–Meier survival curves. Results: This study involved 767 elderly HF patients, 61.3% of whom had malnutrition. In the threshold analysis, HF patients' 6‐month readmission risk was significantly reduced with increasing GNRI, with a hazard ratio (HR) and 95% confidence interval (CI) of 0.99 (0.97.1). Malnutrition group was associated with a higher risk of readmission within 6 months for HF patients in analyses that were controlled for confounding factors, with HRs and their 95% CI of 1.17 (0.99, 1.38), 1.18 (1, 1.4), and 1.44 (1.08,1.93), respectively. Subgroup analysis showed that GNRI levels had a consistent impact on outcome events, unaffected by covariates. Conclusions: GNRI was negatively correlated with the outcome event of readmission within 6 months in elderly HF patients. Malnutrition group showed a higher risk of readmission within 6 months. [ABSTRACT FROM AUTHOR]

Background: Readmissions in psychiatric inpatient care may reflect problems in the provision of care, but the underlying factors are not well known. We examined the associations of patient characteristics (sociodemographic factors, diagnoses), treatment (duration, previous episodes, neuromodulation) and ward overload with psychiatric inpatient readmissions and multiple readmissions in Finland. Methods: We used a routinely collected data pool from one hospital district and followed all 2052 hospitalizations that started in 2018. The outcomes were readmission within 30 days and one year, and among those with readmission, the number of readmissions. Results: Of the patients, 11% had readmission within 30 days and 33% had readmission within one year. Women, those with previous hospitalizations, those with an ICD-10 diagnosis from the 'behavioural syndromes associated with physiological disturbances and physical factors / disorders of adult personality and behaviour' group, those with a diagnosis from the 'neurotic, stress-related and somatoform disorders' group, those with psychotic disorders, and those who received neuromodulation treatment were more likely to have readmissions. Having a diagnosis of 'disorders of psychological development' or 'behavioural and emotional disorders with onset usually occurring in childhood and adolescence' was associated with a lower likelihood of readmission. The duration of treatment and ward overload during the index period were not associated with readmission. Conclusions: The findings of this study suggest possible risk factors for readmission and can be used to plan psychiatric care. To some degree, the risk factors varied between different readmission types. It is important to examine whether there are unmet treatment needs in psychiatric inpatient care for children and adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Malignancy-related ascites (MRA) is a common serious complication of many advanced malignant tumors with high morbidity and mortality. The high hospital expenditures induced by unplanned readmission in patients with MRA have become an urgent issue to the public. We aimed to overall assess the unplanned early readmission rate of patients with MRA and explore the potential risk factors for such readmission. Methods: A retrospective cohort study based on 2018 Nationwide Readmissions Database was performed and patients with MRA were recruited into the analysis. The primary outcome was unplanned 30-day readmission rate and inpatient outcomes. The multivariate logistic regression analysis was performed to evaluate the potential risk factors for such early readmission. Results: Data obtained from 32,457 patients with MRA were analyzed, and of these 7,799 individuals (24.03%) were unplanned readmitted within 30-day follow-up. The mortality rate in the readmitted population was 15.15%. Patients at younger age were at a higher risk of readmission. The morbidities including hypertension (OR=1.117, 95%CI: 1.054-1.184), hyperlipemia (OR=1.075, 95%CI: 1.009-1.146) and diabetes (OR=1.118, 95%CI: 1.053-1.188), gastrointestinal malignancies and peritoneal procedure significantly increased the risk of 30-day readmission in patients with MRA. Discussion: More than one in five patients with MRA was unplanned readmitted within 30-day follow-up. The above risk factors should be timely intervened and the corresponding medical care should be strengthened in patients with MRA to lessen the unplanned readmission and improve the readmission outcomes. [ABSTRACT FROM AUTHOR]

Background: Robotic-assisted technologies have been developed to increase surgical precision and reduce surgical variability in total knee arthroplasty (TKA). Several different robotic systems have been introduced in the last decade for TKA. The DePuy Synthes VELYS™ Robotic-Assisted Solution (VRAS) is an imageless system designed to eliminate the need for preoperative CT scans and is one of the latest entrants in the rapidly evolving field of robotic technology in TKA. This study compared the clinical and economic outcomes associated with VRAS and other robotic-assisted technologies for primary TKA. Methods: A retrospective cohort study using the Premier Healthcare Database included patients who underwent primary TKA with VRAS or other robotic-assisted technologies from January 1, 2022, to April 30, 2023. The primary outcome for the study was hospital follow-up visits (revisits) within 90 days post-TKA. Secondary outcomes included readmission and revision rates within 90 days post-TKA, operating room time, length of stay, discharge status and hospital costs. Cohorts were balanced using propensity score fine stratification, and generalized linear models were constructed to evaluate outcomes. Results: This study included 827 VRAS TKA patients and 16,428 TKA patients treated with other robotic-assisted technologies. The 90-day all-cause and knee-related revisit rates were significantly lower for VRAS than for other robotic-assisted technologies (all-cause 13.9% vs. 22.8% and knee-related 2.8% vs. 5.4%, respectively; p value < 0.01). The all-cause and knee-related 90-day readmission rates were also lower for VRAS, although the differences were not statistically significant. The 90-day revision rates were similar for VRAS and other robotic-assisted technologies (0.48% vs. 0.45%), as was the operating room time (138 vs. 137 min). The 90-day knee-related cost for the VRAS cohort was $15,048 compared to $16,867 for other robotic technologies. Conclusions: This database study demonstrated that early postoperative revisit rates and total cost of care are lower for VRAS than for all other robotic-assisted technologies for TKA, while operating room time and discharge status were similar. These are important findings in ever-evolving healthcare systems that are increasingly cost conscious and cognizant of principles associated with value-based care. [ABSTRACT FROM AUTHOR]

Background: To assess the effect of pneumonia on the risk of mortality and other clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: PubMed, EMBASE and Scopus were screened for observational cohort and case-control studies that reported outcomes in AECOPD patients with and without pneumonia. Pooled effect sizes were reported as relative risks (RR) or hazard ratio (HR) for categorical outcomes and as weighted mean difference (WMD) for continuous outcomes. The primary outcome was mortality. Secondary outcomes were risk of admission to intensive care unit (ICU), need for assisted ventilation and readmission as well as duration of stay at the hospital. The certainty of the evidence was assessed using the GRADE approach. Results: Thirteen studies were included. AECOPD patients with pneumonia had significantly higher risk of in-hospital mortality (RR 2.29, 95% CI: 1.40, 3.73), mortality at 1 month (RR 1.84, 95% CI: 1.09, 3.13), and 1 year or more of follow-up (HR 2.30, 95% CI: 1.15, 4.61) compared to AECOPD patients without pneumonia. Pneumonia was associated with significantly higher risk of admission to ICU (RR 2.79, 95% CI: 1.47, 5.28), need for assisted ventilation (RR 2.02, 95% CI: 1.52, 2.67), and longer hospital stay (in days) (WMD 3.31, 95% CI: 2.33, 4.29). The risk of readmission was comparable in the two groups of patients (RR 1.07, 95% CI: 0.97, 1.19). The overall quality of evidence for the outcomes was judged to be "Low". Conclusion: Pneumonia during acute exacerbation of COPD may lead to increases in both short-term and long-term mortality as well as increased hospital stay, need for ventilatory support and admission to ICU. Our findings suggest the need for close monitoring, early intervention, and long-term follow-up, to improve the outcomes in AECOPD patients with concurrent pneumonia. [ABSTRACT FROM AUTHOR]

Irregular migration is rapidly becoming a permanent feature of the twenty-first century. Amid the European "refugee crisis", Italy and Spain represent two major destination countries that are affected by substantial irregular flows. Despite this comparable condition, and notwithstanding the significance of their relevant policies, they have rarely been compared, a gap in the literature that this research addresses through a novel comparative analysis of their irregular migration governance. Following a broad contextualisation of destination countries' strategies against irregular migration, this article delves into the two case studies' external dimension of control policies from the 1990s to 2024 inclusive. In doing so, it assesses the nature of their foreign policy on irregular migration, their specific measures, and their geographical scope. It finds that there is a noticeable convergence towards readmission measures and externalisation, along with the growing use of informal deals. In terms of differences, the article highlights Italy's much higher number of irregular arrivals compared to Spain, and the impact that this has had on domestic debates, priorities, and relevant policy formulation processes. As a novel investigation of two influential case studies, this article therefore contributes to the literature on both externalisation and Italy's and Spain's foreign policy. [ABSTRACT FROM AUTHOR]

Introduction: Migrant women are a heterogenous group with both higher and lower risk for pregnancy complications and adverse birth outcomes compared with women in the receiving countries. This study aimed to investigate women's use of Swedish healthcare postpartum, in terms of hospital stay >48 h, readmission to hospital, and specialized out‐patient clinic visits, in relation to maternal country of birth. Material and Methods: A population‐based register study including 278 219 primiparous and 367 776 multiparous women in Sweden (2014–2019) using data from Swedish Pregnancy Register, National Patient Register and Statistics Sweden. Multivariable logistic regression analyses were used to estimate associations between maternal country of birth and outcomes, adjusting for year of birth, maternal age, education, pre‐gestational hypertension and diabetes, and healthcare region, presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI) with Swedish‐born women as reference. Results: Subgroups of migrant women had higher odds of postpartum hospital stays > 48 h, particularly women from Eritrea (primiparous aOR 2.80, CI 2.49–3.15; multiparous aOR 2.78, CI 2.59–2.98), Somalia (primiparous aOR 2.61, CI 2.34–2.92; multiparous aOR 1.87, CI 1.79–1.97), and India (primiparous aOR 2.52, CI 2.14–2.97; multiparous aOR 2.61, CI 2.33–2.93), compared to Swedish‐born women. Primiparous women from Afghanistan (aOR 1.32, CI 1.08–1.6), Iraq (aOR 1.30, CI 1.16–1.46), and Iran (aOR 1.23, CI 1.04–1.45) had slightly higher odds of hospital readmission, along with multiparous women from India (aOR 1.34, CI 1.02–1.76) and Somalia (aOR 1.24, CI 1.11–1.38). Specialized out‐patient clinic visits were most common in primiparous women from Somalia (aOR 1.47, CI 1.35–1.59), Iran (aOR 1.31, CI 1.22–1.42) and Afghanistan (aOR 1.31, CI 1.18–1.46), and in multiparous women from Iran (aOR 1.30, CI 1.20–1.41) and Iraq (aOR 1.15, CI 1.11–1.20), however less common in women from some other countries. Conclusions: The use of Swedish health care during the postpartum period varied among women, depending on their country of birth. Women from certain countries had particularly high odds of postpartum hospital stays exceeding 48 h, compared to Swedish‐born women, regardless of parity and pre‐gestational medical disorders. Further studies are needed to determine whether the individual needs of migrant women are being met during the postpartum period or not. [ABSTRACT FROM AUTHOR]