Table 3.
Performance of the risk prediction models for 30- and 90-day readmission for fluid overload among individuals with diabetes and diabetic kidney disease
| For 30-day hospital readmission for fluid overload in diabetes | ||||
|---|---|---|---|---|
| Clinical model | Clinical + psychosocial | Parsimonious model | LACE index | |
| C index | 0.609 | 0.618 | 0.600 | 0.538 |
| AIC | 1,887.7 | 1,883.3 | 1,886.1 | 1,904.7 |
| Optimum cut-off | 0.119 | 0.118 | 0.128 | 0.109 |
| Sensitivity | 0.382 | 0.420 | 0.267 | 0.137 |
| Specificity | 0.847 | 0.824 | 0.906 | 0.931 |
| PPV | 0.189 | 0.182 | 0.210 | 0.157 |
| NPV | 0.936 | 0.938 | 0.930 | 0.920 |
| For 90-day hospital readmission for fluid overload in diabetes | ||||
|---|---|---|---|---|
| Clinical model | Clinical + psychosocial | Parsimonious model | LACE index | |
| C index | 0.660 | 0.659 | 0.629 | 0.546 |
| AIC | 3,755.1 | 3,754.7 | 3,759.1 | 3,795.9 |
| Optimum cut-off | 0.211 | 0.209 | 0.154 | 0.153 |
| Sensitivity | 0.477 | 0.473 | 0.761 | 0.905 |
| Specificity | 0.775 | 0.768 | 0.405 | 0.170 |
| PPV | 0.307 | 0.298 | 0.210 | 0.185 |
| NPV | 0.877 | 0.875 | 0.891 | 0.896 |
| For 30-day hospital readmission for fluid overload in diabetic kidney disease | ||||
|---|---|---|---|---|
| Clinical model | Clinical + psychosocial | Parsimonious model | LACE index | |
| C index | 0.586 | 0.594 | 0.551 | 0.527 |
| AIC | 1,165.3 | 1,162.6 | 1,162.7 | 1,171.7 |
| Optimum cut-off | 0.093 | 0.089 | 0.140 | 0.076 |
| Sensitivity | 0.412 | 0.435 | 0.153 | 0.800 |
| Specificity | 0.750 | 0.739 | 0.949 | 0.266 |
| PPV | 0.128 | 0.130 | 0.210 | 0.089 |
| NPV | 0.935 | 0.936 | 0.926 | 0.937 |
| For 90-day hospital readmission for fluid overload in diabetic kidney disease | ||||
|---|---|---|---|---|
| Clinical model | Clinical + psychosocial | Parsimonious model | LACE index | |
| C index | 0.659 | 0.665 | 0.630 | 0.540 |
| AIC | 2,551.8 | 2,551.2 | 2,552.8 | 2,583.6 |
| Optimum cut-off | 0.160 | 0.162 | 0.207 | 0.164 |
| Sensitivity | 0.789 | 0.784 | 0.547 | 0.926 |
| Specificity | 0.439 | 0.458 | 0.630 | 0.150 |
| PPV | 0.240 | 0.245 | 0.249 | 0.196 |
| NPV | 0.903 | 0.904 | 0.861 | 0.901 |
Clinical model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, hypertension, IV furosemide peak daily dose >80 mg/day.
Clinical + psychosocial model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, hypertension, IV furosemide peak daily dose >80 mg/day, history of alcoholism, current smoker.
Parsimonious model: hospitalization for fluid overload within 6 months before index hospitalization, hypertension, IV furosemide peak daily dose >80 mg/day during hospitalization, history of alcoholism, current smoker.
LACE index: length of stay, acuity of admission, CCI, number of emergency department visits in 6 months before index hospitalization.
Clinical model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, hypertension, atrial fibrillation, CCI ≥7, emergency admission, IV furosemide peak daily dose >80 mg/day, eGFR at discharge ≤45 mL/min/1.73 m2, thiazide at discharge, MRB at discharge, male sex.
Clinical + psychosocial model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, hypertension, atrial fibrillation, CCI ≥7, emergency admission, IV furosemide peak daily dose >80 mg/day, eGFR at discharge ≤45 mL/min/1.73 m2, thiazide at discharge, MRB at discharge, male sex, current smoker.
Parsimonious model: hospitalization for fluid overload within 6 months before index hospitalization, cardiovascular disease, need for IV furosemide peak daily dose >80 mg/day during hospitalization, eGFR at discharge ≤45 mL/min/1.73 m2.
LACE index: length of stay, acuity of admission, CCI, number of emergency department visits in 6 months before index hospitalization.
Clinical model: hospitalization for fluid overload within 6 months before index hospitalization, cardiovascular disease, hypertension, IV furosemide peak daily dose >80 mg/day.
Clinical + psychosocial model: hospitalization for fluid overload within 6 months before index hospitalization, cardiovascular disease, hypertension, IV furosemide peak daily dose >80 mg/day, history of alcoholism.
Parsimonious model: hospitalization for fluid overload within 6 months before index hospitalization, history of alcoholism.
LACE index: length of stay, acuity of admission, CCI, number of emergency department visits in 6 months before index hospitalization.
Clinical model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, atrial fibrillation, CCI ≥7, IV furosemide peak daily dose >80 mg/day, eGFR at discharge ≤45 mL/min/1.73 m2, thiazide at discharge, MRB at discharge, male sex.
Clinical + psychosocial model: hospitalization for fluid overload within 6 months before index hospitalization, two or more emergency visits within 6 months before index hospitalization, cardiovascular disease, atrial fibrillation, CCI ≥7, IV furosemide peak daily dose >80 mg/day, eGFR at discharge ≤45 mL/min/1.73 m2, thiazide at discharge, MRB at discharge, male sex, history of alcoholism.
Parsimonious model: hospitalization for fluid overload within 6 months before index hospitalization, cardiovascular disease, eGFR at discharge ≤45 mL/min/1.73 m2, thiazide at discharge.
LACE index: length of stay, acuity of admission, CCI, number of emergency department visits in 6 months before index hospitalization. eGFR, estimated glomerular filtration rate; IV, intravenous; MRB, mineralocorticoid receptor blocker; AIC, Akaike information criterion.