Departments of Nursing Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) School of Nursing Faculty of Medicine, Department of Clinical Science, University of Barcelona, Barcelona, Spain.
Respirology. 2011 Oct;16(7):1119-26. doi: 10.1111/j.1440-1843.2011.02017.x.
The aim of this study was to identify the frequency of, reasons for, and risk factors associated with additional health-care visits and re-hospitalizations (health-care interactions) among patients with community-acquired pneumonia (CAP), within 30days of discharge from hospital.
This was an observational analysis of a prospective cohort of adults hospitalized with CAP at a tertiary hospital in 2007-2009. Additional health-care interactions were defined as visits to a primary care centre or emergency department, and hospital readmissions within 30days of discharge.
Of the 934 patients hospitalized with CAP, 282 (34.1%) had additional health-care interactions within 30days of discharge from hospital; 149 (52.8%) required an additional visit to a primary care centre and 177 (62.8%) attended the emergency department. Seventy-two patients (25.5%) were readmitted to hospital. The main reasons for additional health-care interactions were worsening of signs or symptoms of CAP and new or worsening comorbidities that were unrelated to pneumonia, mainly cardiovascular and pulmonary diseases. The only independent factor associated with visits to a primary care centre or the emergency department was alcohol abuse (OR 1.65; 95% CI: 1.03-2.64). Hospitalization in the previous 90days (OR 2.47; 95% CI: 1.11-5.52) and comorbidities (OR 3.99; 95% CI: 1.12-14.23) were independently associated with re-hospitalization.
Additional health-care visits and re-hospitalizations within 30days of discharge from hospital were common among patients with CAP. This was mainly due to worsening of signs or symptoms of CAP and/or comorbidities. These findings may have implications for discharge planning and follow up of patients with CAP.
本研究旨在确定社区获得性肺炎（CAP）患者出院后 30 天内额外就诊和再住院（医疗交互）的频率、原因和相关风险因素。
这是对 2007 年至 2009 年在一家三级医院因 CAP 住院的成人进行的前瞻性队列观察性分析。额外的医疗交互被定义为在出院后 30 天内就诊于初级保健中心或急诊部以及住院再入院。
在因 CAP 住院的 934 名患者中，有 282 名（34.1%）在出院后 30 天内有额外的医疗交互；149 名（52.8%）需要额外就诊于初级保健中心，177 名（62.8%）就诊于急诊部。72 名患者（25.5%）再次住院。额外医疗交互的主要原因是 CAP 体征或症状恶化以及与肺炎无关的新的或恶化的合并症，主要是心血管和肺部疾病。唯一与就诊于初级保健中心或急诊部相关的独立因素是酗酒（OR 1.65；95%CI：1.03-2.64）。在过去 90 天内住院（OR 2.47；95%CI：1.11-5.52）和合并症（OR 3.99；95%CI：1.12-14.23）与再住院独立相关。
CAP 患者出院后 30 天内额外就诊和再住院很常见。这主要是由于 CAP 体征或症状恶化和/或合并症所致。这些发现可能对 CAP 患者的出院计划和随访有影响。
