Respiratory Care: Chest Infections |

Patient Characteristics Associated With 30-Day Readmission Following an Index Hospitalization for Pneumonia FREE TO VIEW

Joshua Pregnar, DO; Gus Slotman, MD; Edward Gray, DO
Author and Funding Information

Inspira Health Network, Vineland, NJ

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1234A. doi:10.1016/j.chest.2016.08.1346
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Published online

SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Given the penalties associated with re-admission following index pneumonia admissions, knowing patient characteristics associated with re-admission is important. We therefore sought to identify distinguishing characteristics in patients who were re-admitted (READMIT) versus not readmitted (NO-READMIT) within 30 days of discharge following a hospitalization for pneumonia.

METHODS: Clinical records of 3,350 patients admitted with a primary diagnosis of pneumonia were analyzed to compare READMIT versus NO-READMIT. Data included history and demographics, plus laboratory results within 48 hours of admission, 96 hours before discharge, and 48 hours before discharge.

RESULTS: READMIT v NO-READMIT age (71+-19/57+-29 yrs. P<0.0001), weight (161+-61/151+-73 lbs. p=0.003), ER visits (9.9+-13.6/5.1=-10.6 p<0.0001) and hospital admissions (5.3+-10.8/1.7+-6.2 p<0.0001) in prior 12 months, race (Black 1%, Hispanic 6.7%, Caucasian 72.5%/Black 14.7%, Hispanic 16.5%, Caucasian 67% p<0.001), previous MI (8.1% v 2.9% p<0.0001), atrial fibrillation (27.8% v 15.8% p<0.0001), diabetes (31.3% v 24.5% p=0.003), and health insurance (Private 11.4%, Medicaid 9.6%, Medicare 76.8%, Self-Pay and uninsured 2.2%/Private 16%, Medicaid 20%, Medicare 57%, Self-Pay and uninsured 6.8% p<0.0001) varied significantly. READMIT BUN, creatinine, BUN/creatinine ratio, glucose, osmolality, and % neutrophils were higher than NO-READMIT at all observation points (p<0.0001). READMIT WBC was increased at 96 and 48 hours pre-discharge. READMIT GFR and hemoglobin were lower than NO-READMIT at all three observation points.

CONCLUSIONS: Compared with NO-READMIT, READMIT patients were older, heavier, predominantly Caucasian, and more Medicare insured. Previous MI, Afib, and diabetes were increased among READMIT patients. READMIT had more recent ER visits and hospitalizations than NO-READMIT. READMIT index admission glucose, osmolality, and WBC/% neutrophils were higher and renal function impaired versus NO-READMIT.

CLINICAL IMPLICATIONS: These findings may facilitate identification of pneumonia patients at risk for re-admission and therefore allow more focused discharge planning and closer outpatient follow up in an effort to reduce re-admission risk.

DISCLOSURE: The following authors have nothing to disclose: Joshua Pregnar, Gus Slotman, Edward Gray

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