Patients discharged with unstable vital signs have higher readmission, mortality rates

Editor's Note

Nearly 20% of patients are discharged before all vital signs are stable, which is associated with an increased risk of readmission and death, this study finds.

Of 32,835 patients from six Dallas-Fort Worth, Texas, hospitals analyzed, researchers found abnormalities in temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation within 24 hours of discharge. A total of 18.7% of patients were discharged with one or more of these vital sign instabilities.

Overall, 12.8% of patients with no instabilities on discharge died or were readmitted, compared to 16.9% of patients with one instability, 21.2% with two instabilities, and 26% with three or more instabilities.

These simple vital sign criteria could be used to assess safety for discharge and reduce mortality and readmissions, the authors say.

Oanh Kieu Nguyen Division of General Internal Medicine, Department of Internal Medicine UT Southwestern Medical Center Division of Outcomes and Health Services Research, Department of Clinical Sciences UT Southwestern Medical Center Anil N.