Prediction of Early and Long-Term Hospital Readmission in Patients with Severe Obesity: A Retrospective Cohort Study.

ABSTRACT

Adults with obesity have a higher risk of hospitalization and high hospitalization-related healthcare costs. However, a predictive model for the risk of readmission in patients with severe obesity is lacking. We conducted a retrospective cohort study enrolling all patients admitted for severe obesity (BMI ≥ 40 kg/m2) between 2009 and 2018 to the Istituto Auxologico Italiano in Piancavallo. For each patient, all subsequent hospitalizations were identified from the regional database by a deterministic record-linkage procedure. A total of 1136 patients were enrolled and followed up for a median of 5.7 years (IQR 3.1-8.2). The predictive factors associated with hospital readmission were age (HR = 1.02, 95%CI 1.01-1.03, p < 0.001), BMI (HR = 1.02, 95%CI 1.01-1.03, p = 0.001), smoking habit (HR = 1.17, 95%CI 0.99-1.38, p = 0.060), serum creatinine (HR = 1.22, 95%CI 1.04-1.44, p = 0.016), diabetes (HR = 1.17, 95%CI 1.00-1.36, p = 0.045), and number of admissions in the previous two years (HR = 1.15, 95%CI 1.07-1.23, p < 0.001). BMI lost its predictive role when restricting the analysis to readmissions within 90 days. BMI and diabetes lost their predictive roles when further restricting the analysis to readmissions within 30 days. In conclusion, in this study, we identified predictive variables associated with early and long-term hospital readmission in patients with severe obesity. Whether addressing modifiable risk factors could improve the outcome remains to be established.