• Obstetrics and gynecology · May 2016

    A Multi-State Analysis of Postpartum Readmissions in the United States [26].

    • Mark A Clapp, Sarah E Little, Jie Zheng, and Julian N Robinson.
    • Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA.
    • Obstet Gynecol. 2016 May 1; 127 Suppl 1: 11S.

    IntroductionTo describe the trends in postpartum readmissions over time, to characterize the common indications for readmissions, and to determine maternal, delivery, and hospital characteristics associated with readmission.MethodsPostpartum readmissions (n=114,748) occurring within the first six weeks after delivery in California, Florida, and New York were identified between 2004-2011 in State Inpatient Databases. We calculated the rates of readmissions and their indications by state and over time. The characteristics of the readmission stay were compared among the diagnoses. Odds ratios were calculated using a multivariate logistic regression to determine the predictors of readmission.ResultsThe readmission rate increased from 1.72% in 2004 to 2.16% in 2011. Readmitted patients were more likely to be publicly insured (54.3% vs 42.0%, P<.001), Black (18.7% vs 13.5%, P<.001), have comorbidities, and to have had a cesarean delivery (37.2% vs 32.9%, P<.001). The most common indications for readmission were infection (15.5%), hypertension (9.3%), and psychiatric illness (7.7%). Readmission day varied by diagnosis: day three for hypertension, day five for infection, and day nine for psychiatric disease. Maternal comorbidities were the strongest predictors of postpartum readmissions: psychiatric disease (OR 2.542 [95% CI 2.448-2.600]), substance use (OR 2.016 [95% CI 1.958-2.075]), seizure disorder (OR 1.989 [95% CI 1.873-2.113]), hypertension (OR 1.886 [95% CI 1.839-1.934]), and tobacco use (OR 1.859 [95% CI 1.800-1.921]).Conclusion/ImplicationsUnderstanding the risk factors, etiologies, and cause-specific timing for postpartum readmissions may aid in the development of new quality metrics in obstetrics and targeted strategies to curb the rising rate of postpartum readmissions in the United States.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…