Risk factors for hospital readmissions in pneumonia patients: A systematic review and meta-analysis

Yuan-Yuan Fang; Jian-Chao Ni; Yin Wang; Jian-Hong Yu; Ling-Ling Fu

doi:10.12998/wjcc.v10.i12.3787

Risk factors for hospital readmissions in pneumonia patients: A systematic review and meta-analysis

World J Clin Cases. 2022 Apr 26;10(12):3787-3800. doi: 10.12998/wjcc.v10.i12.3787.

Authors

Yuan-Yuan Fang¹, Jian-Chao Ni¹, Yin Wang², Jian-Hong Yu¹, Ling-Ling Fu³

Affiliations

¹ Department of Geriatrics, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang Province, China.
² Department of Internal Medicine, Yuecheng People's Hospital, Shaoxing 312000, Zhejiang Province, China.
³ Department of Respiratory Medicine, Zhuji Affiliated Hospital of Shaoxing University, Zhuji 311800, Zhejiang Province, China. fu198609262021@sina.com.

Abstract

Background: Factors that are associated with the short-term rehospitalization have been investigated previously in numerous studies. However, the majority of these studies have not produced any conclusive results because of their smaller sample sizes, differences in the definition of pneumonia, joint pooling of the in-hospital and post-discharge deaths and lower generalizability.

Aim: To estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia.

Methods: Systematic search was conducted in PubMed Central, EMBASE, MEDLINE, Cochrane library, ScienceDirect and Google Scholar databases and search engines from inception until July 2021. We used the Newcastle Ottawa (NO) scale to assess the quality of published studies. A meta-analysis was carried out with random-effects model and reported pooled odds ratio (OR) with 95% confidence interval (CI).

Results: In total, 17 studies with over 3 million participants were included. Majority of the studies had good to satisfactory quality as per NO scale. Male gender (pooled OR = 1.22; 95%CI: 1.16-1.27), cancer (pooled OR = 1.94; 95%CI: 1.61-2.34), heart failure (pooled OR = 1.28; 95%CI: 1.20-1.37), chronic respiratory disease (pooled OR = 1.37; 95%CI: 1.19-1.58), chronic kidney disease (pooled OR = 1.38; 95%CI: 1.23-1.54) and diabetes mellitus (pooled OR = 1.18; 95%CI: 1.08-1.28) had statistically significant association with the hospital readmission rate among pneumonia patients. Sensitivity analysis showed that there was no significant variation in the magnitude or direction of outcome, indicating lack of influence of a single study on the overall pooled estimate.

Conclusion: Male gender and specific chronic comorbid conditions were found to be significant risk factors for hospital readmission among pneumonia patients. These results may allow clinicians and policymakers to develop better intervention strategies for the patients.

Keywords: Hospital readmission; Meta-analysis; Pneumonia; Prediction; Systematic review.