{"doi":"10.1001/jamanetworkopen.2025.17974","title":"Hospital Readmissions Among People With Sickle Cell Disease","abstract":"Importance: While advances in the management and treatment of sickle cell disease (SCD), the most common inherited disorder in the United States, have improved outcomes, hospital readmissions remain a significant concern. Thirty-day hospital readmissions is a key quality-of-care indicator; however, there are limited contemporary nationally representative data on SCD readmissions. Objective: To characterize national trends in SCD-related readmissions in the United States and describe factors associated with readmission among patients with SCD. Design, Setting, and Participants: This cohort study included patients with SCD aged 18 years and older. Patients were identified in the Nationwide Readmissions Database (NRD), an all-payer database of US hospitalizations, using International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Data were collected from January 2016 to December 2021 and analyzed from May to September 2024. Main Outcomes and Measures: Readmission was defined as subsequent admission within 30 days of hospitalization discharge using the Centers for Medicare & Medicaid Services methodology. The 30-day all-cause unplanned readmission risk among adults with SCD was estimated, and the trend in 30-day readmissions among adults with and without SCD was assessed by calendar year from 2016 to 2021. Survey-weighted mixed-effect Poisson regressions were used to identify factors associated with readmission. Results: From 2016 to 2021, 140 096 807 all-cause index hospitalizations and 592 951 SCD-related index hospitalizations were analyzed. Patients with SCD had a stable readmission risk of approximately 34% (annual range, 32.6%-34.3%), significantly higher per year than the approximately 12% readmission risk among patients without SCD (annual range, 12.0%-12.2%) (P < .001). In 2021, there were 92 536 index admissions from 37 410 unique patients with SCD (median [IQR] age, 34 [26-46] years; 22 484 [60.1%] female), with 30 467 readmissions. Younger patients (aged 18-29 years) had the highest readmission risk at 35.1%. In multivariable model among patients with SCD, patients from the highest-income zip codes had lower readmission risk than those from lower-income areas (adjusted risk ratio [aRR], 0.90; 95% CI, 0.84-0.97). Admissions paid by Medicare and Medicaid were associated with higher readmission risk than private insurance (Medicare: aRR, 1.67; 95% CI, 1.56-1.78; Medicaid: aRR,1.53; 95% CI, 1.43-1.63). Vaso-occlusive crises at index admission were associated with higher readmission risk (aRR, 1.31; 95% CI, 1.25-1.37). Fewer readmissions were observed in patients receiving simple (aRR, 0.86; 95% CI, 0.82-0.91) and exchange (aRR, 0.78; 95% CI, 0.61-0.99) red blood cell transfusions. Conclusions and Relevance: In this cohort study with nationally representative data, patients with SCD had a significantly higher readmission risk than patients without SCD. Preventative, disease-modifying, and curative interventions are needed to reduce readmission risks and improve outcomes for patients with SCD.","journal":"JAMA Network Open","year":2025,"id":541510,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9567,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":429043,"name":"Ping Yang","orcid":"0000-0002-8588-847X","position":1,"is_corresponding":false},{"id":353472,"name":"Xianming Zhu","orcid":"0000-0002-3317-7449","position":2,"is_corresponding":false},{"id":246863,"name":"Eshan U. Patel","orcid":"0000-0003-2174-5004","position":3,"is_corresponding":false},{"id":1079602,"name":"Elizabeth P. Crowe","orcid":"0000-0003-1910-2800","position":4,"is_corresponding":false},{"id":956166,"name":"Herleen Rai","orcid":"0000-0001-6072-6098","position":5,"is_corresponding":false},{"id":227514,"name":"Evan M. Bloch","orcid":"0000-0001-8181-9517","position":6,"is_corresponding":false},{"id":227515,"name":"Aaron A.R. Tobian","orcid":"0000-0002-0517-3766","position":7,"is_corresponding":false},{"id":454940,"name":"Ruchika Goel","orcid":"0000-0001-9653-9905","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T02:52:47.161928Z","pmid":"40526379","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}