Hospital Readmissions Among Post-acute Nursing Home Residents: Does Obesity Matter?
Shubing Cai, Sijiu Wang, Dana B Mukamel and 2 others
PMID 30853424WHAT IT FOUND
Obesity was not a simple readmission risk factor.
Among oldest old nursing home residents, obesity was linked to higher 30-day readmissions, especially after surgery, but the association weakened after accounting for other conditions.
Key findings
01Obesity was linked to higher readmission risk among oldest old residents before adjustment, but the association was reduced after accounting for other conditions.
02After adjustment, moderate-to-severe obesity remained associated with higher readmission odds for oldest old surgical residents, but not for oldest old medical residents.
03Obesity appeared protective for younger residents before adjustment, but additional risk factors reduced that protective effect for younger surgical residents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Uncaptured health conditions may still confound the relationship between obesity and readmission risk. The analysis excluded residents with BMI lower than 20, so it does not describe low-weight residents. The study only looked at new nursing home admissions, not residents with previous nursing home stays. It only examined post-acute nursing home residents, not long-stay residents. Readmissions were not classified as necessary or unnecessary. The study focused on Medicare beneficiaries, most aged 65 and older, so it does not capture younger post-acute care populations. The payment system's contribution to readmission rates could not be determined.
Declared interests
The authors declared no conflicts of interest. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that obesity causes readmissions. This was an observational association, and the direction changed by age and after adjustment.