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Trial registered on ANZCTR
Registration number
ACTRN12617001362381
Ethics application status
Approved
Date submitted
20/09/2017
Date registered
27/09/2017
Date last updated
27/09/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Early and late predictors of hospital readmissions and whether nutrition status helps predict hospital readmissions
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Scientific title
Predictors of very early and late readmissions in medical patients and whether Malnutrition universal screening tool (MUST) score can predict hospital readmissions
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Secondary ID [1]
292941
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None
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Universal Trial Number (UTN)
U1111-1202-4512
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hospital readmissions
304828
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Malnutrition
304829
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Readmission prediction tools
304830
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Medical inpatients
304831
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Condition category
Condition code
Diet and Nutrition
304130
304130
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0
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Other diet and nutrition disorders
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Public Health
304131
304131
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0
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Epidemiology
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
A retrospective observational study looking into predictors of hospital readmissions within six months of discharge in medical patients and whether nutrition status predicts hospital readmissions
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Intervention code [1]
299174
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Diagnosis / Prognosis
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Intervention code [2]
299175
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Early Detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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This is an exploratory outcome to predict factors which can predict hospital readmissions.
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Assessment method [1]
303451
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Timepoint [1]
303451
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Within seven days, thirty days and six months following hospital discharge.
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Secondary outcome [1]
338955
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Whether nutrition status, as determined by Malnutrition Universal Screening Tool (MUST) score, at time of admission improves prediction power of existing readmission prediction tools.
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Assessment method [1]
338955
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Timepoint [1]
338955
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Within seven days, thirty days and six months of hospital discharge.
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Eligibility
Key inclusion criteria
All medical inpatients admitted between 1st January 2016 to 31 st December 2016
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Surgical and Gynaecology patients and patients less than 18 years of age.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
The variables will be assessed for normality using skewness and kurtosis test. Data will be presented as mean (SD) or median (IQR). Categorical variables will be expressed as frequency and percent and compared using Pearson’s x2 or Fisher’s exact test as appropriate.
Univariate logistic regression will be used to assess the association between nutritional status and unplanned readmission within 7 days, 30 days and 180 days post-discharge. Multivariate logistic regression analysis will be used to test the relationship between readmissions and nutrition status at different time points and will be adjusted for other variables-age, gender, Charlson index, principal diagnosis at presentation, number of medications at admission, length of hospital stay, number of medical emergency response team calls during index admission and total number of hours spent in intensive care unit (ICU). Variance inflation factor and tolerance values will be used to detect collinearity between variables included in the model. A link test will be used to confirm that the linear approach to model the outcome is correct. Model fit will be assessed using the Hosmer-Lemeshow goodness-of–fit test. Kaplan Meier survival curve will be plotted from time of discharge to the first endpoint (readmission) and Log rank test will be utilized used to compare survival proportions in the nourished and malnourished groups. A two-sided p<0.05 will be considered to indicate statistical significance. All analysis will be performed using STATA version 15.0 (StataCorp, College Station, Texas, USA).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2017
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Actual
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Date of last participant enrolment
Anticipated
1/10/2018
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
2819
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
9083
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [2]
9084
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
17576
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5042 - Bedford Park
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Recruitment postcode(s) [2]
17577
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
297567
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Hospital
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Name [1]
297567
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Flinders Medical Centre
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Address [1]
297567
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Flinders Drive
Bedford Park
South Australia 5042
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Country [1]
297567
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Australia
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Primary sponsor type
Hospital
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Name
Flinders Medical Centre
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Address
Flinders Drive
Bedford Park
South Australia 5042
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Country
Australia
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Secondary sponsor category [1]
296581
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None
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Name [1]
296581
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Address [1]
296581
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Country [1]
296581
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298662
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
298662
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Flinders Medical Centre Room 6A219 Flinders Drive Bedford Park South Australia 5042
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Ethics committee country [1]
298662
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Australia
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Date submitted for ethics approval [1]
298662
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Approval date [1]
298662
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04/09/2017
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Ethics approval number [1]
298662
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216.17
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Summary
Brief summary
Hospital readmissions are common and are risky for the patients and imposes additional financial burden on already constrained health care resources. Although numerous readmission predictor tools have been developed their ability to accurately identify patients at high risk of unplanned readmissions is only modest. Experts believe that this could be due to unknown variables, which needs to be identified. Majority of studies predicting hospital readmissions have so far been carried out in United States and only limited studies are available in Australia. Moreover, these studies are centred on 30-day readmission rate, as this is a commonly used benchmark to reimburse hospitals in US. The present study aims to study predictors, which can influence very early and late readmissions in medical inpatients and whether nutrition status as determined by Malnutrition universal screening tool (MUST) can be used as a predictor of hospital readmissions.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
77810
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Dr Yogesh Sharma
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Address
77810
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Level 6
General Medicine
Flinders Medical Centre
Flinders Drive
Bedford Park
South Australia 5042
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Country
77810
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Australia
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Phone
77810
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+61882046694
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Fax
77810
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Email
77810
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[email protected]
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Contact person for public queries
Name
77811
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Yogesh Sharma
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Address
77811
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Level 6
General Medicine
Flinders Medical Centre
Flinders Drive
Bedford Park
South Australia 5042
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Country
77811
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Australia
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Phone
77811
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+61882046694
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Fax
77811
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Email
77811
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[email protected]
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Contact person for scientific queries
Name
77812
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Yogesh Sharma
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Address
77812
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Level 6
General Medicine
Flinders Medical Centre
Flinders Drive
Bedford Park
South Australia 5042
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Country
77812
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Australia
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Phone
77812
0
+61882046694
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Fax
77812
0
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Email
77812
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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