Presence of one or more instabilities linked to increased risk-adjusted odds of death or readmission
MONDAY, Aug. 15, 2016 (HealthDay News) — Among adults with a hospitalization, vital sign instability on discharge is associated with increased risk of 30-day mortality and readmission, according to a study published online Aug. 8 in the Journal of General Internal Medicine.
Oanh Kieu Nguyen, M.D., from the UT Southwestern Medical Center in Dallas, and colleagues conducted a multicenter observational cohort study involving 32,835 adults, aged 18 years or older, with a hospitalization to any medicine service at six hospitals.
The researchers found that 18.7 percent of participants were discharged with instabilities in one or more vital sign. Overall, 12.8 percent of those with no instabilities on discharge died or were readmitted, compared to 16.9, 21.2, and 26.0 percent of those with one, two, and three or more instabilities, respectively (P < 0.001). The presence of any instability correlated with elevated risk-adjusted odds of death or readmission (adjusted odds ratio [aOR], 1.36; 95 percent confidence interval [CI], 1.26 to 1.48), with a stronger association for death (aOR, 2.31; 95 percent CI, 1.91 to 2.79). Compared to those with no instabilities, individuals with three or more instabilities had increased odds of death (aOR, 3.91; 95 percent CI, 1.69 to 9.06) and 30-day readmission (aOR, 1.36; 95 percent CI, 0.81 to 2.30).
“These simple vital sign criteria could be used to assess safety for discharge, and reduce 30-day mortality and readmissions,” the authors write.
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