Risk factors for readmission of rheumatoid arthritis patients receiving integrative medicine: A retrospective analysis

Introduction: An increasing number of rheumatoid arthritis (RA) patients are being readmitted to hospitals. This study was carried out to identify risk factors for readmission of RA patients accessing an integrative medicine setting. Methods: A total of 899 RA patients were identified from the First Affiliated Hospital of Anhui University of Chinese Medicine between May 2012 and June 2015. Hospitalization data and medical records were retrieved from the hospital database. Analyses utilized logistic regression models and odds ratio (OR) comparing readmitted patients and non-readmitted patients. Results: Of the RA patients, mean age was 52.9 years, most patients were female (86.87%) and 15.68% had readmission records within one year. Patients were diagnosed with four traditional Chinese medicine patterns: Wind-damp-heat (71.97%), Wind-damp-cold (2.67%), Phlegm and blood stagnation (17.02%) and Liver and kidney deficiency (8.34%). Comorbidities included hypertension (16.69%), diabetes mellitus (5.9%), coronary artery disease (2%), respiratory disease (1.89%) and liver disorder (1.78%). Factors associated with increased risk of readmission included: anti-streptolysin O positive (OR = 3.245, P < 0.01), rheumatoid factors positive (OR = 1.639, P < 0.05), low haemoglobin levels (OR = 1.525, P < 0.05), comorbidities with respiratory disease (OR = 2.868, P < 0.05) and liver disorder (OR = 7.041, P < 0.001). Patients with Wind-damp-heat pattern had the highest risk of readmission, comparing to patients with other three TCM patterns. Patients were more likely to be readmitted, the closer they lived to the hospital (OR = 0.962, P < 0.01). Conclusions: To the best of our knowledge, this is the first study to explore risk factors for the readmission of RA patients receiving integrative medicine treatment. Of the factors correlated with readmission rates, reduced haemoglobin may be an important and treatable indicator.