{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T09:22:30Z","timestamp":1774603350177,"version":"3.50.1"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>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.<\/jats:p><\/jats:sec>Objective<\/jats:title>To characterize national trends in SCD-related readmissions in the United States and describe factors associated with readmission among patients with SCD.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>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) <\/jats:italic>codes. Data were collected from January 2016 to December 2021 and analyzed from May to September 2024.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Readmission was defined as subsequent admission within 30 days of hospitalization discharge using the Centers for Medicare &amp;amp; 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.<\/jats:p><\/jats:sec>Results<\/jats:title>From 2016 to 2021, 140\u202f096\u202f807 all-cause index hospitalizations and 592\u202f951 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<\/jats:italic>\u2009&amp;lt;\u2009.001). In 2021, there were 92\u202f536 index admissions from 37\u202f410 unique patients with SCD (median [IQR] age, 34 [26-46] years; 22\u202f484 [60.1%] female), with 30\u202f467 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.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>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.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.17974","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T15:00:25Z","timestamp":1750172425000},"page":"e2517974","source":"Crossref","is-referenced-by-count":3,"title":["Hospital Readmissions Among People With Sickle Cell Disease"],"prefix":"10.1001","volume":"8","author":[{"given":"Ruchika","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Simmons Cancer Institute, Division of Hematology-Oncology, Department of Internal Medicine at SIU School of Medicine, Springfield, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianming","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eshan U.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth P.","family":"Crowe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herleen","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron A. 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