Jang Jong Geol, Ahn June Hong
Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
Tuberc Respir Dis (Seoul). 2020 Apr;83(2):147-156. doi: 10.4046/trd.2019.0073. Epub 2020 Mar 10.
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.
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.
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.
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.
针对亚洲人群社区获得性肺炎(CAP)住院后的再入院情况进行评估的研究有限。我们评估了韩国普通成年人群中CAP住院后30天再入院的发生率、原因及风险因素。
我们对2012年3月至2014年2月在庆南大学住院的1021例CAP患者进行了一项回顾性观察研究。主要终点是初次住院出院后30天内的全因再次住院情况。再次住院分为肺炎相关再入院或肺炎无关再入院。
在研究期间,862例存活至出院的患者符合纳入标准,其中72例(8.4%)在30天内再次住院。在多变量分析中,肺炎相关再入院与偏瘫/半身不遂、恶性肿瘤、肺炎严重程度指数分级≥4以及出院时临床不稳定≥1有关。慢性肺病和慢性肾病等合并症、治疗失败以及合并症失代偿与肺炎无关的30天再入院率有关。
CAP患者出院后30天内再次住院很常见。肺炎相关和无关再入院的风险因素不同。预防误吸、在最佳时间出院以及密切监测合并症可能会降低CAP患者的再入院频率。