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Incidence of Unplanned 30-Day Readmissions in Adult Burn Patients in the United States.

Introduction: This study characterizes adult burn readmissions in the United States using a nationally representative hospital inpatient sample. Readmission rates, diagnoses, and risk factors are discussed.

Methods: We analyzed the 2013 and 2014 Nationwide Readmission Database (NRD) for adult burn patients. The data were weighted to estimate national 30-day readmission rates. Principal readmission diagnoses were sorted into burn-specific or other readmission categories. We used multivariable logistic regression to assess the effects of patient and hospital stay risk factors on readmissions.

Results: An estimated 42,957 US adult burn patients were discharged between January and November of 2013 and 2014. Of these patients, an estimated 3,203 had unscheduled readmissions within 30 days [all-cause readmission rate: 7.5%, 95% CI: 6.7 - 8.2]. An estimated 55.4% of unplanned readmissions were for burn-specific principal readmission diagnoses. Burn-specific readmission was associated with burn severity and increased with both patient age and the number of comorbidities. Patients whose length of stay was less than 1 day/% total body surface area (TBSA) burned had higher readmission risk [Adjusted odds ratio (AOR) = 2.10, 95% CI = 1.48 - 2.99]. The results of logistic regression models were similar for burn-specific readmissions and all-cause readmissions.

Conclusions: In a nationally representative sample of adult burn patients, 4.1% had unplanned 30-day readmissions for burn-specific reasons; 7.5% were readmitted for any reason. Patient comorbidities and discharge before 1 day/%TBSA from the hospital impact readmission risk. Healthcare providers can use this information to identify at-risk patients, modify their treatment plans, and prevent readmissions.

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