Scientific article
Open access

The Early HOSPITAL Score to Predict 30-Day Readmission Soon After Hospitalization : a Prospective Multicenter Study

Published inJournal of general internal medicine, vol. 39, no. 5, p. 756-761
Publication date2023-12-13
First online date2023-12-13


The simplified HOSPITAL score is an easy-to-use prediction model to identify patients at high risk of 30-day readmission before hospital discharge. An earlier stratification of this risk would allow more preparation time for transitional care interventions.


To assess whether the simplified HOSPITAL score would perform similarly by using hemoglobin and sodium level at the time of admission instead of discharge.


Prospective national multicentric cohort study.


In total, 934 consecutively discharged medical inpatients from internal general services.

Main Measures

We measured the composite of the first unplanned readmission or death within 30 days after discharge of index admission and compared the performance of the simplified score with lab at discharge (simplified HOSPITAL score) and lab at admission (early HOSPITAL score) according to their discriminatory power (Area Under the Receiver Operating characteristic Curve (AUROC)) and the Net Reclassification Improvement (NRI).

Key Results

During the study period, a total of 3239 patients were screened and 934 included. In total, 122 (13.2%) of them had a 30-day unplanned readmission or death. The simplified and the early versions of the HOSPITAL score both showed very good accuracy (Brier score 0.11, 95%CI 0.10–0.13). Their AUROC were 0.66 (95%CI 0.60–0.71), and 0.66 (95%CI 0.61–0.71), respectively, without a statistical difference ( p value 0.79). Compared with the model at discharge, the model with lab at admission showed improvement in classification based on the continuous NRI (0.28; 95%CI 0.08 to 0.48; p value 0.004).


The early HOSPITAL score performs, at least similarly, in identifying patients at high risk for 30-day unplanned readmission and allows a readmission risk stratification early during the hospital stay. Therefore, this new version offers a timely preparation of transition care interventions to the patients who may benefit the most.

  • Hospital readmission
  • Prediction model
  • Score
Citation (ISO format)
MATHYS, Philippe et al. The Early HOSPITAL Score to Predict 30-Day Readmission Soon After Hospitalization : a Prospective Multicenter Study. In: Journal of general internal medicine, 2023, vol. 39, n° 5, p. 756–761. doi: 10.1007/s11606-023-08538-0
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ISSN of the journal0884-8734

Technical informations

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