Identification of Multimorbid Patients With a Higher Probability of Readmission and Mortality

Identification of Multimorbid Patients With a Higher Probability of Readmission and Mortality: Role of Patient-related Variables

A prospective qualitative quantitative study was designed to create predictive models of readmission in multimorbid patients.

Study Overview

• Status: Completed
• Conditions: Multimorbidity
• Intervention / Treatment: Other: annual follow up

Detailed Description

Social determinants have been shown to be related to the probability of readmission and death in multimorbid patients. These are increasingly older, which makes them more likely to be readmitted when their preferences are usually to be at home. Objective: To create and validate prediction models for readmission and mortality during home transitional period (1 month) and up to a year, in multimorbid patients, including variables related to the patient and their social environment. Design: Quali-quantitative. 4 hospitals from 3 regions (Andalucia, Catalonia and the Basque Country) will participate . Patients presenting at least 2 of the Ollero's categories will be included. Variables will be identified by means of nominal groups of professionals and focal groups with patients and caregivers. These variables will be included in the final models join to clinical variables, PROMS (health related quality of life, burden of the caregiver , social support). Logistic/ Cox regression models will be developed and validated internally to identify the risk of readmission and death which will be validated in an external cohort. Expected results: We hope to provide the health system with stratification tools for polypathological patients that help in identifying those patients with the greatest need for individualized interventions.

• Study Type: Observational
• Enrollment (Actual): 500

Contacts and Locations

Study Locations

• Spain
  • Barcelona, Spain, 08003
    • Hospital Del Mar
  • Sevilla, Spain, 41013
    • Hospital Universitario Virgen del Rocio
  • Bizkaia
    • Galdakao, Bizkaia, Spain, 48960
      • Hospital Galdakao Usansolo
  • Málaga
    • Marbella, Málaga, Spain, 29603
      • Hospital Costa del Sol

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

multimorbid patients who are equivalently complex and with high risk for destabilization, difficult to manage and with mutual interrelationships.

Description

Inclusion Criteria:

• Patients over 18 years of age
• Patients discharged from the Internal Medicine departments of the participating centers due to acute pathology, de novo or decompensation of a chronic pathology who also present at least 2 of the cathegories of Ollero et al.

Exclusion Criteria:

• Patients admitted for end-of-life treatment, scheduled admissions, exacerbation of rheumatic pathology or systemic disease, study of anaemia in patients with no-known comorbidity, search for neoplasia and acute processes without associated comorbidity. -
• Failure to sign the informed consent form.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Admitted; We will include patients who had been admitted by meeting Ollero et al categories in hospitalization ward	Other: annual follow up; Collection of the following information during the year following discharge from the initial episode (initial cohort): readmissions, dates and causes of readmission, mortality

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Readmission	number of readmissions in the early period (transition to discharge, 1 month	1 month
Readmission	number of readmissions in the annual period	1 year

Collaborators and Investigators

• Sponsor: Hospital Galdakao-Usansolo
• Collaborators: Hospital del Mar; Instituto de Salud Carlos III; Hospitales Universitarios Virgen del Rocío; Hospital Costa del Sol; Asociacion Instituto de Investigacion en Servicios de Salud Kronikgune
• Investigators: Principal Investigator: Susana García Gutiérrez, PhD, Unidad de Investigación. Hospital Galdakao-Usansolo. Osakidetza

Study record dates

Study Major Dates

• Study Start (Actual): February 7, 2022
• Primary Completion (Actual): June 30, 2022
• Study Completion (Actual): August 30, 2023

Study Registration Dates

• First Submitted: October 7, 2022
• First Submitted That Met QC Criteria: October 7, 2022
• First Posted (Actual): October 12, 2022

Study Record Updates

• Last Update Posted (Actual): September 22, 2023
• Last Update Submitted That Met QC Criteria: September 21, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: Mortality; Readmission; Predictive; multimorbid Patients
• Other Study ID Numbers: PI18/01438

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No