Hospital Readmissions Among Persons With Human Immunodeficiency Virus in the United States and Canada, 2005-2018: A Collaboration of Cohort Studies

Overview

Journal J Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2023 Sep 12

PMID 37697938

Authors

Thibaut Davy-Mendez

Sonia Napravnik

Brenna C Hogan

Joseph J Eron

Kelly A Gebo

Keri N Althoff

Richard D Moore

Michael J Silverberg

Michael A Horberg

M John Gill

Peter F Rebeiro

Maile Y Karris

Marina B Klein

Mari M Kitahata

Heidi M Crane

Ank Nijhawan

Kathleen A McGinnis

Jennifer E Thorne

Viviane D Lima

Ronald J Bosch

Jonathan A Colasanti

Charles S Rabkin

Raynell Lang

Stephen A Berry

Affiliations

Soon will be listed here.

Abstract

Background: Hospital readmission trends for persons with human immunodeficiency virus (PWH) in North America in the context of policy changes, improved antiretroviral therapy (ART), and aging are not well-known. We examined readmissions during 2005-2018 among adult PWH in NA-ACCORD.

Methods: Linear risk regression estimated calendar trends in 30-day readmissions, adjusted for demographics, CD4 count, AIDS history, virologic suppression (<400 copies/mL), and cohort.

Results: We examined 20 189 hospitalizations among 8823 PWH (73% cisgender men, 38% White, 38% Black). PWH hospitalized in 2018 versus 2005 had higher median age (54 vs 44 years), CD4 count (469 vs 274 cells/μL), and virologic suppression (83% vs 49%). Unadjusted 30-day readmissions decreased from 20.1% (95% confidence interval [CI], 17.9%-22.3%) in 2005 to 16.3% (95% CI, 14.1%-18.5%) in 2018. Absolute annual trends were -0.34% (95% CI, -.48% to -.19%) in unadjusted and -0.19% (95% CI, -.35% to -.02%) in adjusted analyses. By index hospitalization reason, there were significant adjusted decreases only for cardiovascular and psychiatric hospitalizations. Readmission reason was most frequently in the same diagnostic category as the index hospitalization.

Conclusions: Readmissions decreased over 2005-2018 but remained higher than the general population's. Significant decreases after adjusting for CD4 count and virologic suppression suggest that factors alongside improved ART contributed to lower readmissions. Efforts are needed to further prevent readmissions in PWH.

Citing Articles

Hospital readmissions among adults living with and without HIV in the US: findings from the Nationwide Readmissions Database.

Zhu X, Patel E, Berry S, Grabowski M, Abraham A, Davy-Mendez T EClinicalMedicine. 2024; 73:102690.

PMID: 39007069 PMC: 11246008. DOI: 10.1016/j.eclinm.2024.102690.

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