Predictors of 30-day readmission following hospitalisation with community-acquired pneumonia

BMJ Open Respir Res. 2021 Mar;8(1):e000883. doi: 10.1136/bmjresp-2021-000883.

Abstract

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.

Keywords: pneumonia; respiratory infection.

MeSH terms

  • Community-Acquired Infections* / epidemiology
  • Community-Acquired Infections* / therapy
  • Hospitalization
  • Humans
  • Patient Readmission
  • Pneumonia* / epidemiology
  • Pneumonia* / therapy
  • Risk Factors