Factors associated with 30-day readmission after hospitalisation for community-acquired pneumonia in older patients: across-sectional study in seven Spanish regions

被引:33
作者
Toledo, Diana [1 ,2 ]
Soldevila, Nuria [1 ,2 ]
Torner, Nuria [1 ,2 ,3 ]
Perez-Lozano, Maria Jose [4 ]
Espejo, Elena [5 ]
Navarro, Gemma [6 ]
Egurrola, Mikel [7 ]
Dominguez, Angela [1 ,2 ]
机构
[1] Consorcio Ctr Invest Biomed Red, CIBERESP, Epidemiol & Salud Publ, Madrid, Spain
[2] Univ Barcelona, Fac Med, Barcelona, Spain
[3] Agencia Salut Publ Catalunya, Serv Control Epidemiol, Barcelona, Spain
[4] Hosp Valme, UGC Prevenc Promoc & Vigilancia Salud, Seville, Spain
[5] Hosp Terrassa, Unitat Malalties Infeccioses, Barcelona, Spain
[6] Parc Tauli Hosp Univ, Unitat Epidemiol & Avaluacio, Barcelona, Spain
[7] Hosp Galdakao, Serv Neumol, Usansolo, Spain
关键词
ACUTE MYOCARDIAL-INFARCTION; HEART-FAILURE; PROSPECTIVE COHORT; AFTER-DISCHARGE; RISK-FACTORS; ADULTS; REHOSPITALIZATION; PREDICTORS; OUTCOMES; BURDEN;
D O I
10.1136/bmjopen-2017-020243
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Hospital readmission in patients admitted for community-acquired pneumonia (CAP) is frequent in the elderly and patients with multiple cornorbidities, resulting in a clinical and economic burden. The aim of this study was to determine factors associated with 30 -day readmission in patients with CAP. Design A cross-sectional study. Setting The study was conducted in patients admitted to 20 hospitals in seven Spanish regions during two influenza seasons (2013-2014 and 2014-2015). Participants We included patients aged >= 65 years admitted through the emergency department with a diagnosis compatible with CAP. Patients who died during the initial hospitalisation and those hospitalised more than 30 days were excluded. Finally, 1756 CAP cases were included arid of these, 200 (11.39%) were readrnitted. Main outcome measures 30-day readmission. Results Factors associated with 30-day readmission were living with a person aged <15 years (adjusted OR (aOR) 2.10, 95% Cl 1.01 to 4.41), >3 hospital visits during the 90 previous days (aOR 1.53, 95%Cl 1.01 to 2.34), chronic respiratory failure (aOR 1.74, 95% Cl 1.24 to 2.45), heart failure (aOR 1.69, 95%Cl 1.21 to 2.35), chronic liver disease (aOR 2.27, 95% Cl 1.20 to 4.31) and discharge to home with home healthcare (aOR 5.61, 95%Cl 1.70 to 18.50). No associations were found with pneumococcal or seasonal influenza vaccination in any of the three previous seasons. Conclusions This study shows that 11.39% of patients aged >= 65 years initially hospitalised for CAP were readmitted within 30 days after discharge. Rehospitalisation was associated with preventable arid non-preventable factors.
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页数:8
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共 40 条
[1]   A prospective cohort study of healthcare visits and rehospitalizations after discharge of patients with community-acquired pneumonia [J].
Adamuz, Jordi ;
Viasus, Diego ;
Camprecios-Rodriguez, Paula ;
Canavate-Jurado, Olga ;
Jimenez-Martinez, Emilio ;
Isla, Pilar ;
Garcia-Vidal, Carolina ;
Carratala, Jordi .
RESPIROLOGY, 2011, 16 (07) :1119-1126
[2]  
[Anonymous], 2003, European Lung White Book, V2nd, P55
[3]   Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients [J].
Auerbach, Andrew D. ;
Kripalani, Sunil ;
Vasilevskis, Eduard E. ;
Sehgal, Neil ;
Lindenauer, Peter K. ;
Metlay, Joshua P. ;
Fletcher, Grant ;
Ruhnke, Gregory W. ;
Flanders, Scott A. ;
Kim, Christopher ;
Williams, Mark V. ;
Thomas, Larissa ;
Giang, Vernon ;
Herzig, Shoshana J. ;
Patel, Kanan ;
Boscardin, W. John ;
Robinson, Edmondo J. ;
Schnipper, Jeffrey L. .
JAMA INTERNAL MEDICINE, 2016, 176 (04) :484-493
[4]   Understanding the burden of pneumococcal disease in adults [J].
Blasi, F. ;
Mantero, M. ;
Santus, PierAchille ;
Tarsia, P. .
CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 :7-14
[5]  
Bohannon Richard W, 2003, Conn Med, V67, P599
[6]   Impact of Social Factors on Risk of Readmission or Mortality in Pneumonia and Heart Failure: Systematic Review [J].
Calvillo-King, Linda ;
Arnold, Danielle ;
Eubank, Kathryn J. ;
Lo, Matthew ;
Yunyongying, Pete ;
Stieglitz, Heather ;
Halm, Ethan A. .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2013, 28 (02) :269-282
[7]   Predictors of Short-term Rehospitalization Following Discharge of Patients Hospitalized With Community-Acquired Pneumonia [J].
Capelastegui, Alberto ;
Espana Yandiola, Pedro P. ;
Quintana, Jose M. ;
Bilbao, Amaia ;
Diez, Rosa ;
Pascual, Silvia ;
Pulido, Esther ;
Egurrola, Mikel .
CHEST, 2009, 136 (04) :1079-1085
[8]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[9]   The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery [J].
Cook, Chad ;
Coronado, Rogelio A. ;
Bettger, Janet Prvu ;
Graham, James E. .
MUSCULOSKELETAL SCIENCE AND PRACTICE, 2018, 34 :77-82
[10]   Trends in hospitalizations for community-acquired pneumonia in Spain: 2004 to 2013 [J].
de Miguel-Diez, Javier ;
Jimenez-Garcia, Rodrigo ;
Hernandez-Barrera, Valentin ;
Jimenez-Trujillo, Isabel ;
de Miguel-Yanes, Jose M. ;
Mendez-Bailon, Manuel ;
Lopez-de-Andres, Ana .
EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2017, 40 :64-71