Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
Biostatistics, University of Liverpool, Liverpool, UK.
BMJ Open Respir Res. 2021 Mar;8(1). doi: 10.1136/bmjresp-2021-000883.
There is a paucity of UK data to aid healthcare professionals in predicting which patients hospitalised with community-acquired pneumonia (CAP) are at greatest risk of 30-day readmission and to determine which readmissions may occur soonest.
An analysis of CAP cases admitted to nine UK hospitals participating in the Advancing Quality Pneumonia Programme.
An analysis was performed of 12 157 subjects hospitalised with CAP in the Advancing Quality Programme Database. 26% of those discharged were readmitted within 30 days with readmission predicted by comorbidity including non-metastatic cancer, diabetes with complications and chronic kidney disease. 41% and 66% of readmissions occurred within 7 and 14 days of discharge, respectively. Patients readmitted within 14 days were more likely to have metastatic cancer (6.6% vs 4.5%; p=0.03) compared with those readmitted at 15-30 days.
A quarter of patients hospitalised for CAP are readmitted within 30 days; of those, two-thirds are readmitted within 2 weeks. Further research is required to determine whether such readmissions might be preventable through imple menting measures including in-hospital cross-specialty comorbidity management, convalescence in intermediate care, targeted rehabilitation and advanced care planning.
英国缺乏数据来帮助医疗保健专业人员预测因社区获得性肺炎（CAP）住院的患者中哪些患者有 30 天再入院的最大风险，并确定哪些再入院可能发生得最早。
对参与推进质量肺炎计划的九家英国医院收治的 CAP 病例进行分析。
在推进质量计划数据库中对 12157 例因 CAP 住院的患者进行了分析。出院后 26%的患者在 30 天内再次入院，再入院的预测因素包括非转移性癌症、有并发症的糖尿病和慢性肾脏病。41%和 66%的再入院分别发生在出院后 7 天和 14 天内。在 14 天内再次入院的患者更有可能患有转移性癌症（6.6%比 4.5%；p=0.03），而在 15-30 天再次入院的患者则没有。
四分之一因 CAP 住院的患者在 30 天内再次入院；其中，三分之二在 2 周内再次入院。需要进一步研究以确定是否可以通过实施措施来预防这种再入院，包括住院跨专科合并症管理、中级护理康复、针对性康复和高级护理计划。
