Chu C M, Yung C Y, Leung W S, Chan V L, Leung E M
Divisions of Respiratory Medicine, Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong SAR, China.
Respirology. 2001 Jun;6(2):145-9. doi: 10.1046/j.1440-1843.2001.00321.x.
The aim of this study was to examine whether patients with newly diagnosed tuberculosis (TB) discharged to ambulatory treatment are at risk of unplanned readmission through the emergency department within 28 days of discharge, and the risk factors associated with such readmission.
A cohort of 134 patients admitted to an acute medical department with TB, who were subsequently discharged to ambulatory treatment of TB, were studied by a retrospective record review for unplanned readmission in 28 days. Potential risk factors associated with the readmission were recorded during hospital stay and follow-up visits, including age, sex, length of stay, substance abuse, need of assistance in the activities of daily living (ADL), comorbidities, non-compliance, drug complications and use of non-standard drug regimen.
Up to 20.1% of patients were readmitted. Factors independently associated with early unplanned readmission were need of assistance in ADL, drug complications, the need to use a non-standard drug regimen and more than three non-chest comorbidities.
A significant readmission rate was found in these patients and potential risk factors were identified. Ambulatory treatment for TB may not be appropriate for selected patients. Local guidelines for the management of TB patients at high risk of readmission is needed.
本研究旨在探讨新诊断为肺结核（TB）并出院接受门诊治疗的患者在出院后28天内通过急诊科再次非计划入院的风险，以及与这种再次入院相关的风险因素。
对134例入住急性内科病房且患有肺结核、随后出院接受肺结核门诊治疗的患者进行回顾性记录审查，以研究其在28天内的非计划再次入院情况。在住院期间和随访过程中记录与再次入院相关的潜在风险因素，包括年龄、性别、住院时间、药物滥用、日常生活活动（ADL）是否需要协助、合并症、不依从性、药物并发症以及是否使用非标准药物治疗方案。
高达20.1%的患者再次入院。与早期非计划再次入院独立相关的因素包括ADL需要协助、药物并发症、需要使用非标准药物治疗方案以及三种以上非胸部合并症。
在这些患者中发现了显著的再次入院率，并确定了潜在风险因素。肺结核门诊治疗可能不适用于部分患者。需要制定针对有再次入院高风险的肺结核患者的当地管理指南。
