Table 2.
Major findings of studies reporting reason readmission after hospitalization for pneumonia
| Author (Reference) | Year | Country | Major Findings |
|---|---|---|---|
| Studies with claims assessment to determine of cause for readmission | |||
| Hedlund (22) | 1995 | Sweden | 20.7% of patients were readmitted with pneumonia within average of 31 mo follow-up period; 8.1 episodes pneumonia per 100 person-years in pneumonia survivors vs. 1.2 in survivors of nonpneumonia hospitalizations. |
| Hedlund (22) | 1995 | Sweden | At 6 mo, 22% of patients were readmitted. Readmissions for respiratory tract infections occurred in 5.3%. The next most common reasons for readmission were vascular diseases (5.3%) and malignancy (3.2%). |
| Metersky (29) | 2000 | United States | At 30 d, 3.4% of patients readmitted with pneumonia. |
| Bohannon (30) | 2003 | United States | All-cause readmissions were 16.8% at 30 d, 35.6% at 6 mo, and 46% at 1 yr. At 1 yr, 8.1% of patients were readmitted for pneumonia-related causes. The next most common causes were CHF (3.8%), COPD (1.8%), and sepsis (1.7%) |
| Polić-Vizintin (21) | 2005 | Croatia | At 1 yr, 12.2% of patients were rehospitalized with pneumonia. (Readmissions within 30 d were excluded, as these were believed to be nonresolution of the index pneumonia.) |
| Johnstone (24) | 2008 | Canada | Pneumonia-related readmissions occurred in 2.2% at 30 d, 9.2% at 1 yr, and 16% during the median 3.8 yr of follow-up. At study end, 72% of patients had been readmitted, and 69% had a pneumonia-unrelated readmission. Of the pneumonia-unrelated readmissions at 3.8 yr, the most common reasons were other respiratory diagnoses, circulatory disorders, digestive disorders, fall-related injuries, and cancer. |
| Jencks (12) | 2009 | United States | At 30 d, 20.1% of patients were readmitted. Pneumonia-related admissions occurred in 5.9%. The next most common reasons for readmissions were heart failure (1.5%), COPD (1.2%), and septicemia (0.7%). |
| Dharmarajan (13) | 2013 | United States | At 30 d, 18.3% of patients were readmitted. Pneumonia accounted for 4.1% of admissions. The next most common reasons for readmission were heart failure (1.6%), COPD/asthma (1.4%), sepsis (1.1%), renal disorders (1.0%), cardiorespiratory failure (0.8%), arrhythmias (0.5%), Clostridium difficile infection (0.5%), urinary tract infection (0.4%), gastrointestinal hemorrhage (0.4%), and stroke/TIA (0.4%). |
| HCUP (NIS, patients 18+ yr) (19) | 2009–2011 | United States | At 30 d, 18.1% of patients ≥ 65 yr and 16.8% of all adult patients ≥ 18 yr were readmitted for any cause. The rate of 30-d readmission for primary diagnosis of pneumonia was 3.2 and 3.0% in ≥ 65 yr and ≥ 18 yr, respectively. The rate of 30-d readmission for primary or secondary diagnosis of pneumonia was 7.5 and 7.0% in ≥ 65 yr and ≥ 18 yr, respectively. |
| Studies with chart review to determine of cause for readmission | |||
| Jasti (23) | 2008 | United States | At 30 d, 12.1% of patients were readmitted. Pneumonia-related admissions occurred in 2.5% and nonpneumonia readmissions in 9.0%; the remaining 0.6% were attributed to both pneumonia and other causes. Of the comorbidity-related readmissions, the most common reasons were cardiovascular (3.3%), pulmonary (1.0%), neurologic (1.0%), gastrointestinal (0.9%), genitourinary (0.9%), orthopedic (0.7%), and neoplastic (0.5%). |
| Capelastegui (25) | 2009 | Spain | At 30 d, 7.3% of patients were readmitted. 2.5% had pneumonia-related readmissions, 4.7% had pneumonia-unrelated readmissions. Of the pneumonia-unrelated readmissions, the most common reasons for readmission were cardiovascular (1.6%), pulmonary (1.1%), gastrointestinal (0.6%), orthopedic (0.2%), and neurologic (0.2%). |
| Adamuz (26) | 2011 | Spain | At 30 d, 8.7% of patients were readmitted. Pneumonia-related readmissions occurred in 3.4%, and pneumonia-unrelated readmissions in 3.7%. The remainder were attributed to both pneumonia and other causes. Of the nonpneumonia readmissions, the most common reasons were cardiovascular (1.5%), pulmonary (1.0%), neoplastic (0.6%), and infection (0.2%). |
| Aliberti (27) | 2011 | United States | At 30 d, 13.6% of patients were readmitted. Pneumonia-related readmissions occurred in 3.9% and pneumonia-unrelated readmissions in 9.7%. |
| Shorr (28) | 2013 | United States | At 30 d, 19.3% of patients were readmitted. Pneumonia readmission occurred in 1.4%. The most common reasons for readmission were COPD (4.8%) and CHF (4.4%). Infection (including pneumonia) occurred in 3.4%. |
Definition of abbreviations: CHF = congestive heart failure; COPD = chronic obstructive pulmonary disease; HCUP = Healthcare Cost and Utilization Project; NIS = Nationwide Inpatient Sample; TIA = transient ischemic attack.
For each percentage reported in this table, the denominator is patients discharged alive from the hospital.