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Predictors of 30-day readmission following hospitalisation with community-acquired pneumonia
Biswajit Chakrabarti1, Steven Lane2, Tom Jenks3
1Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK biz@doctors.org.uk.
Insights
A quarter of patients hospitalized with community-acquired pneumonia (CAP) are readmitted within 30 days, with most readmissions occurring within two weeks. Comorbidities like cancer and kidney disease predict readmission risk.
Area of Science:
- Pulmonary Medicine
- Healthcare Analytics
- Geriatric Care
Background:
- Limited UK data exists for predicting 30-day readmission risk in community-acquired pneumonia (CAP) patients.
- Identifying patients at high risk for early readmission is crucial for resource allocation and patient management.
Purpose of the Study:
- To analyze UK data on CAP hospitalizations to identify predictors of 30-day readmission.
- To determine the timing of readmissions following discharge for CAP.
Main Methods:
- Analysis of 12,157 CAP cases from nine UK hospitals in the Advancing Quality Pneumonia Programme.
- Statistical analysis to identify factors associated with 30-day readmissions.
Main Results:
- 26% of discharged CAP patients were readmitted within 30 days.
- Comorbidities such as non-metastatic cancer, diabetes with complications, and chronic kidney disease predicted readmission.
- 41% and 66% of readmissions occurred within 7 and 14 days, respectively.
- Metastatic cancer was associated with earlier readmission (within 14 days).
Conclusions:
- A significant proportion of CAP patients experience 30-day readmissions, with a majority occurring within two weeks.
- Further research is needed to explore preventative strategies like integrated comorbidity management and rehabilitation.
Background:
There is a paucity of UK data to aid healthcare professionals in predicting which patients hospitalised with community-acquired pneumonia (CAP) are at greatest risk of 30-day readmission and to determine which readmissions may occur soonest.
Methods:
An analysis of CAP cases admitted to nine UK hospitals participating in the Advancing Quality Pneumonia Programme.
Results:
An analysis was performed of 12 157 subjects hospitalised with CAP in the Advancing Quality Programme Database. 26% of those discharged were readmitted within 30 days with readmission predicted by comorbidity including non-metastatic cancer, diabetes with complications and chronic kidney disease. 41% and 66% of readmissions occurred within 7 and 14 days of discharge, respectively. Patients readmitted within 14 days were more likely to have metastatic cancer (6.6% vs 4.5%; p=0.03) compared with those readmitted at 15-30 days.
Conclusions:
A quarter of patients hospitalised for CAP are readmitted within 30 days; of those, two-thirds are readmitted within 2 weeks. Further research is required to determine whether such readmissions might be preventable through imple menting measures including in-hospital cross-specialty comorbidity management, convalescence in intermediate care, targeted rehabilitation and advanced care planning.
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