Table 2.
Adverse Events in Hospitalized Patients with Uncomplicated Community-Acquired Pneumonia, by Quarter
| Patients, No. (%)a | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2017 | 2018 | 2019 | 2020 | |||||||||||
| Outcome 30 d After Discharge | Q2(n = 669) | Q3(n = 468) | Q4(n = 500) | Q1 (n = 633) | Q2(n = 523) | Q3(n = 533) | Q4(n = 409) | Q1 (n = 471) | Q2(n = 596) | Q3(n = 501) | Q4(n = 483) | Q1(n = 533) | aOR per Q (95% CI)b | P Valueb |
| Composite adverse outcomec | 127 (19.0) | 99 (21.2) | 100 (20.0) | 114 (18.0) | 107 (20.5) | 116 (21.8) | 82 (20.0) | 82 (17.4) | 98 (16.4) | 76 (15.2) | 79 (16.4) | 86 (16.1) | 0.98 (.96–.99) | .008d |
| Deathc | 6 (0.9) | 11 (2.4) | 3 (0.6) | 8 (1.3) | 11 (2.1) | 6 (1.1) | 6 (1.5) | 1 (0.2) | 8 (1.3) | 5 (1.0) | 5 (1.0) | 4 (0.8) | 0.97 (.91–1.04) | .38 |
| Readmissionc | 49 (7.3) | 46 (9.8) | 38 (7.6) | 39 (6.2) | 43 (8.2) | 53 (9.9) | 43 (10.5) | 38 (8.1) | 42 (7.0) | 30 (6.0) | 45 (9.3) | 41 (7.7) | 1.00 (0.98–1.03) | .78 |
| Urgent visitc,d | 55 (8.2) | 42 (9.0) | 61 (12.2) | 69 (10.9) | 52 (9.9) | 59 (11.1) | 40 (9.8) | 44 (9.3) | 55 (9.2) | 45 (9.0) | 28 (5.8) | 45 (8.4) | 0.98 (.95–1.00) | .07 |
| Antibiotic-associated ADEc | 33 (4.9) | 21 (4.5) | 15 (3.0) | 26 (4.1) | 19 (3.6) | 15 (2.8) | 8 (2.0) | 6 (1.3) | 11 (1.8) | 7 (1.4) | 16 (3.3) | 8 (1.5) | 0.91 (.87–.95) | <.001d |
| CDIe | 2 (0.3) | 1 (0.2) | 1 (0.2) | 3 (0.5) | 0 (0) | 0 (0) | 1 (0.2) | 1 (0.2) | 1 (0.2) | 0 (0) | 3 (0.6) | 1 (0.2) | 1.00 (.86–1.17) | .97 |
| Physician reportedf | 12 (1.8) | 11 (2.4) | 7 (1.4) | 15 (2.4) | 8 (1.5) | 9 (1.7) | 2 (0.5) | 3 (0.6) | 5 (0.8) | 5 (1.0) | 9 (1.9) | 4 (0.8) | 0.93 (.87–.99) | .02d |
| Patient reportedf | 21 (6.2) | 10 (4.4) | 8 (3.3) | 12 (4.0) | 11 (4.5) | 8 (3.2) | 5 (2.9) | 2 (0.9) | 6 (2.1) | 2 (0.9) | 6 (2.8) | 4 (1.6) | 0.89 (.84–.95) | <.001d |
Abbreviations: ADE, adverse drug event; aOR, adjusted odds ratio; CDI, Clostridioides difficile infection; CI, confidence interval; Q, quarter.
Raw proportions of patients hospitalized with uncomplicated community-acquired pneumonia, by quarter, who had an adverse event within 30 days of hospital discharge.
aORs and the associated P values are shown for the change over time (by quarter) in adverse outcomes. aORs were obtained from logistic regression models, adjusting for hospital clustering and predictors known to be associated with each outcome.
Data on composite outcome, deaths, readmissions, and urgent visits were adjusted for age, Charlson comorbidity index, sex, pneumonia severity index, length of stay, Medicaid insurance status, and concurrent disease exacerbations (eg, chronic obstructive pulmonary disease, and heart failure).
Any urgent visit not resulting in hospitalization, including emergency department visits, urgent care visits, and observation stays.
CDI data were adjusted for age, Charlson comorbidity index, inflammatory bowel disease, immunosuppression medications, tube feeds, proton pump inhibitor, length of stay, antibiotic use in the prior 90 days, and number of antibiotics in the prior 90 days.
Data on physician- and patient-reported adverse events were adjusted for age, Charlson comorbidity index, and sex. Patient-reported ADEs were obtained via 30-day follow-up phone call. Of the 6669 patients contacted to ascertain patient-reported adverse events, 3888 (58.3%) responded.