Background/Purpose: Rheumatoid Arthirits (RA) is associated with heightened morbidity, diminished quality of life, and increased healthcare expenses. This research aims to bridge this gap by conducting a comprehensive examination of 30-day readmissions in RA patients, seeking to uncover independent predictors, determine the principal factors contributing to these readmissions and offer insights for targeted interventions to improve healthcare quality in a nationally representative sample of RA patients.

Methods: In this retrospective investigation, the 2019 data from Nationwide Readmission Database were utilized. The primary focus was on determining the rate of readmission for all causes within 30 days post-discharge. Secondary objectives included assessing hospital-level metrics. The identification of independent risk factors for readmission was carried out through Cox regression analysis.

Results: The study examined 7,806 index admissions of RA patients, identifying 90 readmissions. The majority were female (69.15% index, 76.61% readmissions). Medicare covered 58.76% of index cases, decreasing to 40.81% in readmissions. Notably, 35.48% of index and 24.87% of readmitted patients were smokers. Large hospitals (56.22% index, 65.41% readmissions) in metropolitan areas (60.4% index, 63.09% readmissions) were predominant. The most common co-morbidities included hypertension (60.01% index, 55.61% readmissions), osteoarthritis (25.20% index, 15.97% readmissions), and chronic prednisone use (13.91% index, 33.72% readmissions). Most common diagnosis in RA patients’ readmissions included highlighted unspecified RA (M06.9) and Adult-Onset Still’s Disease (M06.1). Age demonstrated a significant inverse association (Adjusted Odds Ratio: 0.96, p< 0.001), while females exhibited a non-significant increase (1.52, p=0.215). Medicaid-insured patients had higher odds (2.77, p< 0.004), but no significant associations were observed for other insurance types. Various co-morbidities, such as Congestive Heart Failure (CHF), showed potential significance (0.036, p=0.097).  Notably, alcohol consumption (4.5, p< 0.0001) and liver conditions (4.09, p< 0.05) emerged as strong positive predictors.

Conclusion: In this nationally representative study, the most substantial risk factors for 30-day readmission in RA patients were female gender, younger age, public insurance, and higher comorbidity scores. Understanding these demographics and co-morbidities is crucial for developing targeted interventions to reduce RA re-admissions. The study recommends early diagnosis, regular monitoring, multidisciplinary care, patient education, and clinical guidelines to reduce readmissions and improve RA patient outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/30-day-readmission-among-patients-with-rheumatoid-arthritis-and-their-independent-predictors-insights-from-national-readmission-database/