title: Identifying risk of readmission in hospitalized elderly adults through inpatient medication exposure.
abstract: OBJECTIVE
  To use electronic health record (EHR) data to examine the association between inpatient medication exposure and risk of hospital readmission.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Tertiary and quaternary care academic health system in Durham, North Carolina.
  
  
  METHODS
  All individuals aged 60 and older who were residents of Durham County, North Carolina and were hospitalized and discharged alive from Duke University Hospital between 2007 and 2009 (N = 4,627).
  
  
  METHODS
  Independent variables were inpatient exposure to individual medication classes. Primary outcome was readmission to a Duke Health System hospital within 30 days.
  
  
  RESULTS
  Readmission rate was 21% (n = 955). In adjusted models, exposure to anticonvulsants (odds ratio OR 1.26, 95% confidence interval (CI) = 1.08-1.48), benzodiazepines (OR = 1.23, 95% CI = 1.04-1.44), corticosteroids (OR = 1.26, 95% CI = 1.07-1.50), and opioids (OR = 1.25, 95% CI = 1.06-1.47) was associated with greater likelihood of readmission. Exposure to antidepressants (OR = 1.85, 95% CI = 1.16-2.96) and opioids on the cardiology service (OR = 1.76, 95% CI = 1.01-3.07) and exposure to opioids on the medicine service (OR = 1.94, 95% CI = 1.17-3.22) were associated with greater odds of readmission than for individuals on the surgery service.
  
  
  CONCLUSIONS
  Exposure of hospitalized elderly adults to certain medication classes was associated with greater likelihood of readmission. Incorporating medication data from EHRs may improve the performance of hospital readmission prediction models.
authors.affiliation: Division of Geriatrics, Duke University Medical Center, Durham, North Carolina; Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Juliessa M
authors.initials: JM
authors.lastname: Pavon
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Eleanor
authors.initials: E
authors.lastname: McConnell
authors.forename: S Nicole
authors.initials: SN
authors.lastname: Hastings
mesh_terms: D000368:Aged; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: electronic health record; medications; readmissions