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Pavon JM, Zhao Y, McConnell E, Hastings SN. Identifying risk of readmission in hospitalized elderly adults through inpatient medication exposure. Journal of the American Geriatrics Society. 2014 Jun 1; 62(6):1116-21.
OBJECTIVE: To use electronic health record (EHR) data to examine the association between inpatient medication exposure and risk of hospital readmission. DESIGN: Retrospective, observational study. SETTING: Tertiary and quaternary care academic health system in Durham, North Carolina. PARTICIPANTS: All individuals aged 60 and older who were residents of Durham County, North Carolina and were hospitalized and discharged alive from Duke University Hospital between 2007 and 2009 (N = 4,627). MEASUREMENTS: Independent variables were inpatient exposure to individual medication classes. Primary outcome was readmission to a Duke Health System hospital within 30 days. RESULTS: Readmission rate was 21% (n = 955). In adjusted models, exposure to anticonvulsants (odds ratio OR 1.26, 95% confidence interval (CI) = 1.08-1.48), benzodiazepines (OR = 1.23, 95% CI = 1.04-1.44), corticosteroids (OR = 1.26, 95% CI = 1.07-1.50), and opioids (OR = 1.25, 95% CI = 1.06-1.47) was associated with greater likelihood of readmission. Exposure to antidepressants (OR = 1.85, 95% CI = 1.16-2.96) and opioids on the cardiology service (OR = 1.76, 95% CI = 1.01-3.07) and exposure to opioids on the medicine service (OR = 1.94, 95% CI = 1.17-3.22) were associated with greater odds of readmission than for individuals on the surgery service. CONCLUSION: Exposure of hospitalized elderly adults to certain medication classes was associated with greater likelihood of readmission. Incorporating medication data from EHRs may improve the performance of hospital readmission prediction models.