SAUD SAAD ALASMARI, FAHAD MOHAMMED ALWADANI, TARIQ ABDULLAH ALI ALSHAHRANI, ABDULLAH ALI ALASMI, ABDULLAH MOHAMMED ALOMI, AHMED MOHAMMED ABDULLAH ALOMAI, EID BASHEER AYED ALENAZY, MOHAMMED SHAFI MOHAMMED ALANAZI ,MOHAMMED HOUSSAIN HAMDI, ALI MURDI MOHSEN ALQARNI, FAHAD MESFER M. ALOTAIBI, ALI YAHYA ABDULLAH EZZI, AHMED SALEH AHMED ALZAHRANI, KHETAM MOSFER EID ALOTAIBI, ALAA MOSFER EID ALOTAIBI
DOI: https://doi.org/Background Thirty-day unplanned readmission is a key transition-of-care metric. We developed and internally validated a pragmatic prediction approach using routinely available discharge-time information, including laboratories from the prior 24–48 hours.
Methods Retrospective cohort of consecutive adult discharges from medical and surgical wards. Eligible index stays ended in live discharge; deaths, direct acute transfers, discharges against medical advice without window labs, and planned returns were excluded. Outcome was all-cause, unplanned readmission within 30 days to the same hospital. Two logistic models were fit: a core model (age, sex, length of stay, prior 90-day discharge, prior 12-month admissions, HOSPITAL points) and an extended model adding discharge-proximal labs (e.g., CRP, eGFR, troponin). Model fit, calibration, discrimination, classification, and collinearity were assessed.
Results Among 913 patients (mean age 55.8 years; 54.8% male), 30-day readmission was 12.3% (n=112). The core model retained age, length of stay, prior 90-day discharge, and HOSPITAL points, with good calibration (Hosmer–Lemeshow p=0.239), high specificity, and low sensitivity at the default threshold. The extended model (N=339) added CRP and eGFR, modestly increased Nagelkerke R² (0.10→0.14) and sensitivity (to 8.8%); AUC=0.683; collinearity acceptable (VIF 1.01–1.41).
Conclusion Recent utilization and near-discharge biological instability jointly shaped 30-day readmission. A universal core model is deployable for all patients; routine laboratories provide incremental signal where available.
