Appendix Definitions of Index Admission and Readmission Definitions of index admission and readmission follow CMS hospital-wide all-cause unplanned readmission (HWR) measure as far as data are available. Index admission: any eligible admission to an acute care hospital, according to the following inclusion/exclusion criteria. Inclusion criteria: a. Patient is 65 or older b. Patient survives hospitalization Exclusion criteria: a. Patients discharged against medical advice (AMA) are excluded b. Admissions for medical treatment of cancer are excluded Table Cancer discharge condition categories excluded from the measure AHRQ CCS Description 42 Secondary malignancies 19 Cancer of bronchus; lung 45 Maintenance chemotherapy; radiotherapy 44 Neoplasms of unspecified nature or uncertain behavior 17 Cancer of pancreas 38 Non-Hodgkin`s lymphoma 39 Leukemias 14 Cancer of colon 40 Multiple myeloma 35 Cancer of brain and nervous system 16 Cancer of liver and intrahepatic bile duct 13 Cancer of stomach 29 Cancer of prostate 15 Cancer of rectum and anus 18 Cancer of other GI organs; peritoneum 12 Cancer of esophagus 11 Cancer of head and neck 27 Cancer of ovary 33 Cancer of kidney and renal pelvis 32 Cancer of bladder 24 Cancer of breast 43 Malignant neoplasm without specification of site 25 Cancer of uterus 36 Cancer of thyroid 21 Cancer of bone and connective tissue 41 Cancer; other and unspecified primary 20 Cancer; other respiratory and intrathoracic
23 Other non-epithelial cancer of skin 26 Cancer of cervix 28 Cancer of other female genital organs 34 Cancer of other urinary organs 37 Hodgkin`s disease 22 Melanomas of skin 31 Cancer of other male genital organs 30 Cancer of testis c. Admissions for primary psychiatric disease are excluded Table Psychiatric discharge condition categories excluded from the measure AHRQ CCS Description 657 Mood disorders 659 Schizophrenia and other psychotic disorders 651 Anxiety disorders 670 Miscellaneous disorders 654 Developmental disorders 650 Adjustment disorders 658 Personality disorders 652 Attention-deficit, conduct, and disruptive behavior disorders 656 Impulse control disorders, NEC 655 Disorders usually diagnosed in infancy, childhood, or adolescence 662 Suicide and intentional self-inflicted injury d. Admissions for rehabilitation care; fitting of prostheses and adjustment devices (CCS 254) are excluded Readmission: a subsequent inpatient admission to any acute care facility which occurs within 30 days of the discharge date of an eligible index admission. Note that a readmission within 30-days will also be eligible as an index admission, if it meets all other eligibility criteria. This allows our measure to capture repeated readmissions for the same patient, whether at the same hospital or another. We defined the outcome as all-cause unplanned readmissions rather than readmissions related to the previous hospitalization.
Risk Adjustment Methods To account for differences in patient clinical characteristics that might be related to the readmission outcome, we took a similar approach developed by Yale New Haven Health Services Corporation/Center for Outcomes Research & Evaluation (YNHHSC/CORE) for the hospital-wide all-cause unplanned readmission (HWR) measure. We adjusted both for case mix differences (clinical status of the patient, or comorbidities that were not due to complications) and service mix differences (the types of conditions cared for by the hospital, or the discharge condition category). Comorbidities were assessed using diagnosis data from the index admission and any admissions in the prior year. Specifically, we used secondary and comorbidity ICD-9 discharge diagnosis codes from the index admission, and all discharge diagnosis codes (primary, secondary, and comorbidity) from admissions in the 12 months prior to the index admission. To exclude potential complications occurring during hospitalization from comorbidities used for risk adjustment, we further excluded diagnoses if they appeared only on the index admission (but not in any historic admission). We then grouped these diagnoses into 31 comorbid risk factors using the CMS Condition Category (CMS-CC) Classification (crosswalk between ICD-9 codes and CMS-CCs can be found at www.qualitynet.org). The condition categories were defined using the principal discharge diagnosis of the index admission. These were grouped into 285 mutually-exclusive diagnosis condition categories using the Agency for Healthcare Research and Quality (AHRQ) Clinical Classification Software (AHRQ-CCS). For each of the top 10 frequent condition categories we created a conditionspecific indicator in the model; all other conditions were grouped together into an other category.
Crosswalk between CMS-CCs and Risk Variable (RV) Groups Risk Variable CMS-CC Description rv1 1, 3-5 Severe infection rv2 6, 111-113 Other infectious disease & pneumonias rv3 7 Metastatic cancer/acute leukemia rv4 8, 9 Severe cancer rv6 10, 11, 12 Other major cancers rv9 15-20, 119, 120 Diabetes mellitus rv10 21 Protein-calorie malnutrition rv11 25, 26 End-Stage liver disease rv12 44 Other hematologoical disorders rv14 51, 52 Drug and Alcohol disorders rv15 54-56, 58, 60 Psychiatric comorbidity rv18 67-69, 100-102, 177, 178 Hemiplegia, paraplegia, paralysis, functional disability rv19 74 Seizure disorders and convulsions rv20 80 CHF rv21 81-84, 89, 98, 99, 103-106 Coronary atherosclerosis or angina, cerebrovascular disease rv24 92, 93 Specified arrhythmias rv26 108 Chronic obstructive pulmonary disease rv27 109 Fibrosis of lung or other chronic lung disorders rv29 130 Dialysis Status rv30 148, 149 Ulcers rv31 2 Septicemia/shock rv32 22, 23 Disorders of fluid, electrolyte, acid-base rv33 47 Iron deficiency rv34 79 Cardio-respiratory failure or cardio-respiratory shock rv39 131 Acute Renal failure rv40 32 Pancreatic disease rv41 38 Rheumatoid arthritis and inflammatory connective tissue disease rv42 77 Respirator dependence/tracheostomy status rv43 128, 174 Transplants rv44 46 Coagulation defects and other specified hematological disorders rv45 158 Hip fracture/dislocation
Crosswalk between ICD-9 Codes and AHRQ-CCS Categories AHRQ-CCS Description ICD-9 108 Congestive heart failure; nonhypertensive 39891 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289 2 Septicemia (except in labor) 0031 0202 0223 0362 0380 0381 03810 03811 03812 03819 0382 0383 03840 03841 03842 03843 03844 03849 0388 0389 0545 449 77181 7907 100 Acute myocardial infarction 4100 41000 41001 41002 4101 41010 41011 41012 4102 41020 41021 41022 4103 41030 41031 41032 4104 41040 41041 41042 4105 41050 41051 41052 4106 41060 41061 41062 4107 41070 41071 41072 4108 41080 41081 41082 4109 41090 41091 41092 109 Acute cerebrovascular disease 237 Complication of device; implant or graft 34660 34661 34662 34663 430 431 4320 4321 4329 43301 43311 43321 43331 43381 43391 4340 43400 43401 4341 43410 43411 4349 43490 43491 436 27950 27951 27952 27953 41402 41403 41404 41405 41407 44030 44031 44032 56960 56961 56969 59682 59683 62931 62932 99600 99601 99602 99603 99604 99609 9961 9962 99630 99631 99632 99639 9964 99640 99641 99642 99643 99644 99645 99646 99647 99649 99651 99652 99653 99654 99655 99656 99657 99659 9966 99660 99661 99662 99663 99664 99665 99666 99667 99668 99669 9967 99670 99671 99672 99673 99674 99675 99676 99677 99678 99679 99680 99681 99682 99683 99684 99685 99686 99687 99688 99689 99690 99691 99692 99693 99694 99695 99696 99699 99931 99932 99933 127 Chronic obstructive pulmonary disease and bronchiectasis 490 4910 4911 4912 49120 49121 49122 4918 4919 4920 4928 494 4940 4941 496 159 Urinary tract infections 03284 59000 59001 59010 59011 5902 5903 59080 59081 5909 5950 5951 5952 5953 5954 59581 59582 59589 5959 5970 59780 59781 59789 59800 59801 5990 106 Cardiac dysrhythmias 4270 4271 4272 42731 42732 42760 42761 42769 42781 42789 4279 7850 7851 122 Pneumonia (except that caused by tuberculosis or 00322 0203 0204 0205 0212 0221 0310 0391 0521 0551 0730 0830 1124 1140 1144 1145 11505 11515 11595 1304 1363 sexually transmitted disease) 4800 4801 4802 4803 4808 4809 481 4820 4821 4822 4823 48230 48231 48232 48239 4824 48240 48241 48242 48249 4828 48281 48282 48283 48284 48289 4829 483 4830 4831 4838 4841 4843 4845 4846 4847 4848 485 486 5130 5171 55 Fluid and electrolyte disorders 2760 2761 2762 2763 2764 2765 27650 27651 27652 2766 27669 2767 2768 2769
Selection of Study Cohort: Inclusion/Exclusion Criteria Medicare FFS Admissions of Patients >=65, Discharged 2010 (N=7,845) Admissions with an in- hospital death (N=309) Starting Cohort (N=7,536) Exclusions Discharged against medical advice (N=34) Medical treatment for cancer (N=670) Primary psychiatric (N=35) Hospitalizations with rehabilitation CCS 254 (N=35) Study Cohort before Reconciliation (N=6,762) Additions Adjustment for minor discrepancies between CMS and CDS files * (N=70 ) Final Study Cohort (N=6,832) Note: * Minor discrepancies between CMS and CDS files included slightly different admission/discharge dates and main insurance types. Adjustments were made to be consistent with CMS records.
Prevalence of Clinical Risk Factors among Patients with and without Any Readmission Followed By A Readmission Clinical Risk Factor All No Yes p-value N 6,832 5,525 1,307 Frequent discharge conditions congestive heart failure; non-hypertensive (CCS 108) 7.2% 6.6% 9.6% <.001 septicemia (except in labor) (CCS 2) 3.9% 3.7% 4.8% 0.063 acute myocardial infarction (CCS 100) 3.8% 3.7% 4.5% 0.165 acute cerebrovascular disease (CCS 109) 3.8% 4.1% 2.8% 0.027 complication of device; implant or graft (CCS 237) 3.6% 3.5% 3.8% 0.582 chronic obstructive pulmonary disease and bronchiectasis (CCS 127) 3.4% 3.3% 3.8% 0.376 urinary tract infections (CCS 159) 3.4% 3.4% 3.8% 0.474 cardiac dysrhythmias (CCS 106) 3.1% 3.2% 2.5% 0.212 pneumonia (CCS 122) 2.8% 2.7% 3.4% 0.189 fluid and electrolyte disorders (CCS 55) 2.8% 2.8% 3.1% 0.543 Comorbid risk factors severe Infection (RV1) 1.2% 1.1% 1.6% 0.118 other infectious disease & pneumonias (RV2) 1.8% 1.5% 3.3% <.001 metastatic cancer/acute leukemia (RV3) 3.3% 2.9% 5.0% <.001 severe cancer (RV4) 5.5% 5.1% 7.0% 0.009 other major cancers (RV6) 5.0% 4.7% 6.7% 0.002 diabetes mellitus (RV9) 37.2% 36.6% 39.6% 0.048 protein-calorie malnutrition (RV10) 4.2% 3.6% 6.6% <.001 end-stage liver disease (RV11) 2.1% 1.9% 3.1% 0.010 other hematological disorders (RV12) 1.7% 1.4% 3.1% <.001 drug and alcohol disorders (RV14) 2.2% 2.1% 2.5% 0.301 psychiatric comorbidity (RV15) 11.2% 11.1% 11.5% 0.722 hemiplegia, paraplegia, paralysis, functional disability (RV18) 8.5% 8.2% 9.6% 0.111 seizure disorders and convulsions (RV19) 4.7% 4.5% 5.7% 0.067 CHF (RV20) 10.3% 9.0% 15.8% <.001 coronary atherosclerosis or angina, cerebrovascular disease (RV21) 47.7% 46.9% 51.2% 0.005 specified arrhythmias (RV24) 24.4% 23.7% 27.1% 0.011 coronary obstructive pulmonary disease (RV26) 15.4% 14.7% 18.4% 0.001 fibrosis of lung or other chronic lung disorders (RV27) 1.4% 1.3% 2.0% 0.061 dialysis status (RV29) 3.3% 2.7% 6.0% <.001 ulcers (RV30) 3.7% 3.3% 5.4% <.001 septicemia/shock (RV31) 0.3% 0.3% 0.5% 0.097 disorders of fluid, electrolyte, acid-base (RV32) 6.6% 5.8% 10.2% <.001 iron deficiency (RV33) 7.4% 6.3% 12.1% <.001 cardiorespiratory failure or cardiorespiratory shock (RV34) 0.6% 0.4% 1.1% 0.002 acute renal failure (RV39) 13.7% 11.7% 21.7% <.001 pancreatic disease (RV40) 1.2% 1.1% 1.5% 0.349 rheumatoid arthritis and inflammatory connective tissue (RV41) 3.2% 3.3% 2.6% 0.188 respirator dependence/tracheostomy status (RV42) 0.7% 0.7% 0.9% 0.380 transplants (RV43) 2.4% 2.5% 2.0% 0.313 coagulation defects/other specified hematological disorders (RV44) 6.0% 5.9% 6.4% 0.504 hip fracture/dislocation (RV45) 0.4% 0.3% 0.5% 0.535 Note: Differences between readmission groups are tested by chi-square test.
Associations of Clinical Risk Factors with 30-Day Readmission (Study Unit: Admission) Base (N=6,832) Poverty (N=6,732) Education (N=6,733) Household Income (N=6,735) All-In (N=6,732) Clinical Risk Factor OR 95% CI OR 95% CI OR 95% CI OR 95% CI OR 95% CI Condition Indicator congestive heart failure; non-hypertensive (CCS 108) 1.41 1.12 1.79 1.40 1.11 1.78 1.39 1.10 1.76 1.40 1.11 1.77 1.40 1.11 1.77 septicemia (except in labor) (CCS 2) 1.13 0.83 1.54 1.11 0.81 1.53 1.12 0.82 1.54 1.11 0.81 1.52 1.11 0.81 1.52 acute myocardial infarction (CCS 100) 1.41 1.03 1.92 1.44 1.05 1.97 1.43 1.05 1.96 1.43 1.04 1.95 1.44 1.05 1.96 acute cerebrovascular disease (CCS 109) 0.66 0.45 0.99 0.67 0.45 1.00 0.66 0.44 0.99 0.67 0.45 1.00 0.67 0.45 1.00 complication of device; implant or graft (CCS 237) 1.04 0.75 1.46 1.01 0.72 1.42 1.02 0.73 1.44 1.02 0.72 1.43 1.01 0.72 1.43 chronic obstructive pulmonary disease and bronchiectasis (CCS 127) 1.26 0.90 1.76 1.16 0.82 1.64 1.17 0.83 1.65 1.16 0.82 1.63 1.16 0.82 1.63 urinary tract infections (CCS 159) 1.19 0.85 1.66 1.15 0.82 1.62 1.15 0.82 1.62 1.16 0.82 1.63 1.15 0.82 1.61 cardiac dysrhythmias (CCS 106) 0.90 0.61 1.32 0.89 0.60 1.32 0.89 0.60 1.32 0.89 0.60 1.31 0.89 0.60 1.32 pneumonia (CCS 122) 1.21 0.84 1.72 1.20 0.84 1.72 1.20 0.84 1.71 1.21 0.85 1.73 1.20 0.84 1.71 fluid and electrolyte disorders (CCS 55) 1.05 0.73 1.52 1.05 0.72 1.51 1.05 0.73 1.52 1.05 0.73 1.52 1.04 0.72 1.51 Comorbid Risk Variable severe Infection (RV1) 1.43 0.85 2.41 1.46 0.86 2.48 1.43 0.84 2.44 1.44 0.85 2.45 1.46 0.86 2.49 other infectious disease & pneumonias (RV2) 1.29 0.85 1.94 1.31 0.87 1.99 1.30 0.86 1.96 1.31 0.86 1.98 1.31 0.87 1.99 metastatic cancer/acute leukemia (RV3) 1.52 1.09 2.12 1.52 1.09 2.13 1.51 1.08 2.12 1.53 1.10 2.14 1.52 1.09 2.13 severe cancer (RV4) 1.26# 0.96 1.65 1.26# 0.96 1.65 1.26# 0.96 1.65 1.26# 0.96 1.65 1.26# 0.96 1.66 other major cancers (RV6) 1.32 1.01 1.73 1.31 1.00 1.73 1.32 1.00 1.73 1.33 1.01 1.75 1.32 1.00 1.73 diabetes mellitus (RV9) 1.11 0.98 1.27 1.10 0.96 1.26 1.10 0.96 1.25 1.11 0.97 1.26 1.10 0.96 1.26 protein-calorie malnutrition (RV10) 1.81 1.38 2.38 1.76 1.34 2.33 1.76 1.33 2.32 1.77 1.34 2.34 1.76 1.33 2.33 end-stage liver disease (RV11) 1.63 1.10 2.44 1.64 1.10 2.46 1.63 1.09 2.44 1.62 1.08 2.42 1.64 1.10 2.46 other hematological disorders (RV12) 1.89 1.25 2.85 1.89 1.24 2.87 1.88 1.24 2.86 1.90 1.25 2.89 1.89 1.24 2.86 drug and alcohol disorders (RV14) 1.14 0.75 1.72 1.12 0.74 1.69 1.12 0.74 1.70 1.14 0.75 1.72 1.11 0.74 1.69 psychiatric comorbidity (RV15) 1.13 0.93 1.38 1.13 0.93 1.38 1.14 0.93 1.39 1.14 0.93 1.39 1.13 0.93 1.38 hemiplegia, paraplegia, paralysis, functional disability (RV18) 1.33 1.05 1.69 1.36 1.07 1.72 1.35 1.07 1.71 1.35 1.06 1.71 1.35 1.07 1.72 seizure disorders and convulsions (RV19) 1.22 0.92 1.61 1.22 0.92 1.61 1.24 0.94 1.64 1.24 0.93 1.63 1.22 0.92 1.61 CHF (RV20) 1.28 1.03 1.58 1.29 1.04 1.60 1.28 1.03 1.59 1.29 1.04 1.60 1.28 1.04 1.59 coronary atherosclerosis or angina, cerebrovascular disease (RV21) 0.98 0.86 1.12 0.97 0.85 1.11 0.97 0.85 1.12 0.97 0.85 1.12 0.97 0.85 1.11 specified arrhythmias (RV24) 1.12 0.97 1.30 1.12 0.96 1.29 1.12 0.97 1.30 1.11 0.96 1.29 1.12 0.97 1.30 coronary obstructive pulmonary disease (RV26) 1.18# 1.00 1.40 1.18# 1.00 1.40 1.19 1.00 1.41 1.18# 1.00 1.40 1.18# 1.00 1.40 fibrosis of lung or other chronic lung disorders (RV27) 1.75 1.10 2.81 1.81 1.13 2.91 1.81 1.13 2.90 1.80 1.12 2.89 1.82 1.13 2.92 dialysis status (RV29) 1.49 1.06 2.09 1.48 1.06 2.09 1.50 1.07 2.11 1.49 1.06 2.09 1.49 1.06 2.09 ulcers (RV30) 1.30# 0.96 1.75 1.28 0.94 1.73 1.30# 0.96 1.76 1.28 0.95 1.74 1.28 0.94 1.74 septicemia/shock (RV31) 1.00 0.38 2.63 0.95 0.36 2.52 0.97 0.37 2.56 0.98 0.37 2.59 0.94 0.35 2.50 disorders of fluid, electrolyte, acid-base (RV32) 1.10 0.86 1.41 1.10 0.86 1.41 1.08 0.84 1.39 1.09 0.85 1.39 1.09 0.85 1.41 iron deficiency (RV33) 1.22 0.96 1.56 1.21 0.94 1.54 1.21 0.95 1.55 1.20 0.94 1.53 1.21 0.94 1.54 cardiorespiratory failure or cardiorespiratory shock (RV34) 1.74 0.88 3.46 1.73 0.87 3.44 1.73 0.87 3.43 1.73 0.87 3.43 1.72 0.87 3.42 acute renal failure (RV39) 1.40 1.12 1.75 1.43 1.14 1.79 1.42 1.13 1.78 1.43 1.14 1.79 1.43 1.14 1.79 pancreatic disease (RV40) 1.35 0.79 2.30 1.32 0.76 2.28 1.31 0.76 2.26 1.29 0.75 2.23 1.32 0.77 2.29 rheumatoid arthritis and inflammatory connective tissue disease (RV41) 0.85 0.58 1.24 0.84 0.57 1.24 0.84 0.57 1.23 0.83 0.57 1.23 0.84 0.57 1.24 respirator dependence/tracheostomy status (RV42) 1.15 0.59 2.26 1.19 0.60 2.35 1.21 0.61 2.39 1.18 0.60 2.33 1.18 0.60 2.35 transplants (RV43) 0.77 0.49 1.20 0.80 0.51 1.26 0.79 0.51 1.24 0.80 0.51 1.25 0.81 0.52 1.26 coagulation defects and other specified hematological disorders (RV44) 0.96 0.74 1.24 0.93 0.72 1.22 0.94 0.72 1.22 0.93 0.72 1.22 0.93 0.72 1.22 hip fracture/dislocation (RV45) 1.57 0.60 4.07 1.36 0.49 3.78 1.35 0.48 3.76 1.32 0.47 3.68 1.36 0.49 3.79
Associations of Clinical Risk Factors with 30-Day Readmission (Study Unit: Patient) 0 vs. >0 readmission (N=4,574) 0, 1, >1 readmission (N=4,574) Clinical Risk Factor OR 95% CI OR 95% CI Condition Indicator congestive heart failure; non-hypertensive (CCS 108) 2.19 1.66 2.88 2.49 1.91 3.24 septicemia (except in labor) (CCS 2) 2.25 1.64 3.09 2.23 1.65 3.00 acute myocardial infarction (CCS 100) 2.08 1.51 2.88 2.13 1.56 2.91 acute cerebrovascular disease (CCS 109) 0.84 0.56 1.27 0.87 0.58 1.31 complication of device; implant or graft (CCS 237) 1.87 1.32 2.64 2.20 1.58 3.06 COPD and bronchiectasis (CCS 127) 2.22 1.52 3.24 2.10 1.47 3.02 urinary tract infections (CCS 159) 2.25 1.61 3.15 2.33 1.69 3.22 cardiac dysrhythmias (CCS 106) 1.55 1.07 2.26 1.66 1.16 2.37 pneumonia (CCS 122) 1.75 1.21 2.53 1.79 1.26 2.55 fluid and electrolyte disorders (CCS 55) 2.43 1.71 3.47 2.34 1.68 3.27 Comorbid Risk Variable severe Infection (RV1) 2.00 1.09 3.69 2.33 1.32 4.12 other infectious disease & pneumonias (RV2) 1.32 0.77 2.26 1.68 1.03 2.74 metastatic cancer/acute leukemia (RV3) 1.58 1.05 2.38 1.67 1.13 2.47 severe cancer (RV4) 1.57 1.12 2.19 1.53 1.11 2.12 other major cancers (RV6) 2.04 1.50 2.77 2.20 1.64 2.95 diabetes mellitus (RV9) 1.37 1.16 1.62 1.36 1.15 1.60 protein-calorie malnutrition (RV10) 2.54 1.87 3.45 2.74 2.06 3.64 end-stage liver disease (RV11) 1.84 1.12 3.02 1.75 1.09 2.82 other hematological disorders (RV12) 1.84 1.10 3.08 1.78 1.09 2.88 drug and alcohol disorders (RV14) 1.11 0.70 1.76 1.13 0.73 1.76 psychiatric comorbidity (RV15) 1.45 1.16 1.81 1.43 1.15 1.77 hemiplegia, paraplegia, paralysis, functional disability (RV18) 1.49 1.13 1.98 1.56 1.18 2.05 seizure disorders and convulsions (RV19) 1.45 1.04 2.02 1.40 1.02 1.92 CHF (RV20) 1.07 0.77 1.48 1.09 0.80 1.48 coronary atherosclerosis/angina, cerebrovascular disease (RV21) 1.20 1.01 1.43 1.23 1.04 1.47 specified arrhythmias (RV24) 1.40 1.17 1.67 1.44 1.21 1.72 coronary obstructive pulmonary disease (RV26) 1.32 1.07 1.61 1.35 1.10 1.64 fibrosis of lung or other chronic lung disorders (RV27) 1.92 1.13 3.27 1.72 1.03 2.88 dialysis status (RV29) 1.99 1.16 3.42 1.78 1.09 2.92 ulcers (RV30) 1.58 1.08 2.31 1.60 1.11 2.30 septicemia/shock (RV31) 0.79 0.24 2.60 0.92 0.31 2.75 disorders of fluid, electrolyte, acid-base (RV32) 1.23 0.88 1.73 1.34# 0.97 1.85 iron deficiency (RV33) 1.79 1.28 2.49 1.79 1.31 2.44 cardiorespiratory failure or cardiorespiratory shock (RV34) 1.64 0.71 3.79 1.60 0.76 3.38 acute renal failure (RV39) 1.25 0.90 1.73 1.26 0.92 1.73 pancreatic disease (RV40) 1.27 0.70 2.32 1.34 0.75 2.41 rheumatoid arthritis and inflammatory connective tissue (RV41) 1.02 0.66 1.57 0.97 0.63 1.48 respirator dependence/tracheostomy status (RV42) 0.90 0.38 2.11 1.05 0.46 2.41 transplants (RV43) 0.78 0.43 1.41 0.82 0.47 1.45 coagulation defects/other specified hematological disorders (RV44) 1.25 0.95 1.66 1.29# 0.99 1.69 hip fracture/dislocation (RV45) 0.77 0.21 2.81 0.84 0.23 3.02 Note: Highlighted numbers indicate associations statistically significant at p < 0.05; # indicates p < 0.10