Background: The HOSPITAL score is an internationally validated risk assessment to identify patients at risk of 30 day readmission for adults discharged from an inpatient medical department.1The HOSPITAL score is validated for all hospital admissions – acute and chronic. The purpose of this study was to assess the use of the HOSPITAL score to predict readmissions among patients with an acute condition, specifically for patients with acute venous thromboembolism (VTE).Methods: A random stratified sample of hospital discharges with principal diagnosis codes of VTE were extracted from administrative data to conduct a case-control comparison (9/2014 – 8/2016). The seven predictor variables from the HOSPITAL score were extracted via electronic chart review, and included the following: hemoglobin, discharge from oncology service, sodium level, procedure during the index admission, index type of admission (urgent), number of admissions during the last 12 months, and length of stay. The range of the HOSPITAL score is 0-15 with a greater score indicating a higher risk for readmission. Risk for readmission is categorized into three groups, low risk (0-4 points), intermediate risk (5-6 points) and high risk (≥7 points).

Results: 194 hospital discharges were reviewed; of these, 76 were readmitted within 30 days of hospitalization. VTE patients who were readmitted had similar demographics when compared to the VTE patients who were not readmitted with the exception of race (Table 1). The average HOSPITAL score for patients who were readmitted (5.38) was significantly higher than the average score among patients who were not readmitted (4.27, p < 0.01).

Conclusions: The HOSPITAL score identified patients who were at risk for 30 day readmissions after hospital admission for acute VTE. The HOSPITAL risk score is unique in that it predicts readmissions among patients admitted for acute and chronic conditions whereas most scores predict readmissions for chronic conditions. These findings suggest that the score may help to identify patients with acute VTE at high risk for readmission to allocate transitions of care resources more efficiently. Additional analysis with the complete VTE population during the time period is warranted to assess the readmission rate for each risk category.

1. Donze, Jacques D., Mark V. Williams, Edmondo J. Robinson, Eyal Zimlichman, Drahomir Aujesky, Eduard E. Vasilevskis, Sunil Kripalani et al. “International Validity of the HOSPITAL Score to Predict 30-Day Potentially Avoidable Hospital Readmissions.” JAMA internal medicine 176, no. 4 (2016): 496-502.