(Scientific Session) Factors Associated with Increased Readmission Following Inpatient Rehab Post Spinal Cord Injury, Traumatic Brain Injury, Total Knee Arthroplasty, Total Hip Arthroplasty

Background and/or Objectives: Knowledge of the demographic and clinical characteristics associated with increased 30-day hospital readmissions after discharge from inpatient rehabilitation (IPR) could help predict clinical outcomes and identify high-risk patients. This study aims to identify factors for the future development of a risk stratification tool to assist with clinical decision-making.

Design: Retrospective longitudinal study

Setting: 2018 and 2019 Nationwide Readmissions Database (NRD), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality

Participants: Using ICD-10-CM and ICD-10-PCS codes, we identified 25,852 patients who presented to the hospital and were admitted to IPR during their initial stay for the following conditions or procedures: traumatic brain injury (TBI), spinal cord injury (SCI), total hip arthroplasty (THA), and total knee arthroplasty (TKA). Patients were identified who were readmitted to acute care within 30 days after discharge from IPR.

Interventions: Not applicable

Main Outcome Measures: Demographics such as sex, weekend admission, age group, income quartile, payer type, rural/urban setting as well as clinical characteristics such as length of stay and other concomitant diagnoses were compared between readmitted and not readmitted groups.

Results: We identified 9971 TBI patients (1004 readmitted, 8967 not readmitted), 1536 SCI patients (122 readmitted, 1414 not readmitted), 5735 THA patients (385 readmitted, 5350 not readmitted) THA, and 8610 TKA patients (330 readmitted, 8280 not readmitted). Characteristics that correlated with increased likelihood of readmission were age 74+, Medicare payer type, and male sex. Clinical characteristics such as length of hospital stay and other concomitant diagnoses did not differ between groups.

Conclusions: Using a nationally representative database, this study examined the association of demographic and clinical characteristics with 30-day readmission rates for readmitted and non-readmitted patients who received inpatient rehabilitation for TBI or SCI or after THA or TKA. These differences warrant future studies to identify high-risk patients and prevent readmissions.