Abstract
Background
One of the goals of the Affordable Care Act is to decrease hospital readmissions.
While widely adhered to, there is no published research to support the practice of
delaying discharge if patients exhibit fever or hypothermia in the preceding 24 h,
which is the focus of our study.
Methods
Retrospective analysis of the minimal (Tmin) and maximal (Tmax) body temperatures
collected during the last 24 h before discharge of 19,038 inpatients. Fever was defined
as Tmax >99.5F (+1SD from the mean Tmax) or >100.2F (+2SDs), and hypothermia as Tmin
<97.1F (-1SD from the mean Tmin) or <96.7F (-2SDs).
Results
The overall readmission rate was 10.2% (highest for General Medicine and Pediatrics).
The rate of readmission was not different between normothermic patients and those
with abnormal body temperature, except for higher readmission rate (12.2%) for patients
with fever at 1SD from Tmax compared with normothermic patients (9.96%). Neither fever
nor hypothermia was associated with shorter time to readmission, except for fever
at 2 SDs from Tmax (10.6 days) compared with normothermic patients (12.6 days). Surprisingly,
univariate analysis revealed that higher Tmax and older age were associated with lower
readmission probability. Both uni- and multivariate analysis showed that the presence
of fever is associated with lower readmission probability. Evaluating 200 individual
cases, the most common explanation for body temperature abnormality was infection
and 90% of the preventable readmissions were due to infection.
Conclusions
Abnormal body temperature 24 h prior to discharge was not useful for predicting the
probability of readmission.
Key Indexing Terms
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Article info
Publication history
Published online: July 05, 2022
Accepted:
June 29,
2022
Received:
November 16,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
