Tuberc Respir Dis.  2020 Apr;83(2):147-156. 10.4046/trd.2019.0073.

Reasons and Risk Factors for Readmission Following Hospitalization for Community-acquired Pneumonia in South Korea

• Jang JG
• Ahn JH

• KMID: 2471891
• DOI: http://doi.org/10.4046/trd.2019.0073

Abstract

BACKGROUND
Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea.
METHODS
We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission.
RESULTS
During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate.
CONCLUSION
Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

Keyword

Risk Factors; Pneumonia; Koreans; Hospital Readmission; Causes

MeSH Terms

Adult
Asian Continental Ancestry Group
Comorbidity
Hospitalization*
Humans
Korea*
Lung Diseases
Observational Study
Patient Readmission
Pneumonia*
Renal Insufficiency, Chronic
Retrospective Studies
Risk Factors*
Treatment Failure

Figure

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  Figure 1 Study design: 1,021 index hospitalizations for community-acquired pneumonia were identified. After excluding patients who died during the index hospitalization, those who discharged themselves against medical advice and refused outpatient follow-up, and those transferred to another acute care facility, the final cohort comprised 862 patients.

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  Figure 2 Readmission rate according to number of risk factors.

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