RT Journal Article
SR Electronic
T1 Factors associated with 30-day readmission after hospitalisation for community-acquired pneumonia in older patients: a cross-sectional study in seven Spanish regions
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e020243
DO 10.1136/bmjopen-2017-020243
VO 8
IS 3
A1 Toledo, Diana
A1 Soldevila, Núria
A1 Torner, Núria
A1 Pérez-Lozano, María José
A1 Espejo, Elena
A1 Navarro, Gemma
A1 Egurrola, Mikel
A1 Domínguez, Ángela
A1 ,
YR 2018
UL http://bmjopen.bmj.com/content/8/3/e020243.abstract
AB Objective Hospital readmission in patients admitted for community-acquired pneumonia (CAP) is frequent in the elderly and patients with multiple comorbidities, 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 and of these, 200 (11.39%) were readmitted.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% CI 1.01 to 4.41), >3 hospital visits during the 90 previous days (aOR 1.53, 95% CI 1.01 to 2.34), chronic respiratory failure (aOR 1.74, 95% CI 1.24 to 2.45), heart failure (aOR 1.69, 95% CI 1.21 to 2.35), chronic liver disease (aOR 2.27, 95% CI 1.20 to 4.31) and discharge to home with home healthcare (aOR 5.61, 95% CI 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 and non-preventable factors.