Predictors of early hospital readmission after acute pulmonary embolism.

Détails

ID Serval
serval:BIB_0EF04D213DEC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Predictors of early hospital readmission after acute pulmonary embolism.
Périodique
Archives of Internal Medicine
Auteur⸱e⸱s
Aujesky D., Mor M.K., Geng M., Stone R.A., Fine M.J., Ibrahim S.A.
ISSN
1538-3679[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
169
Numéro
3
Pages
287-293
Langue
anglais
Résumé
BACKGROUND: Risk factors for early mortality after pulmonary embolism (PE) are widely known. However, it is uncertain which factors are associated with early readmission after PE. We sought to identify predictors of readmission after an admission for PE. METHODS: We studied 14 426 patient discharges with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania from January 1, 2000, to November 30, 2002. The outcome was readmission within 30 days of presentation for PE. We used a discrete proportional odds model to study the association between time to readmission and patient factors (age, sex, race, insurance, discharge status, and severity of illness), thrombolysis, and hospital characteristics (region, teaching status, and number of beds). RESULTS: Overall, 2064 patient discharges (14.3%) resulted in a readmission within 30 days of presentation for PE. The most common reasons for readmission were venous thromboembolism (21.9%), cancer (10.8%), pneumonia (5.2%), and bleeding (5.0%). In multivariable analysis, African American race (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.02-1.38), Medicaid insurance (OR, 1.54; 95% CI, 1.31-1.81), discharge home with supplemental care (OR, 1.40; 95% CI, 1.27-1.54), leaving the hospital against medical advice (OR, 2.84; 95% CI, 1.80-4.48), and severity of illness were independently associated with readmission; readmission also varied by hospital region. CONCLUSIONS: Early readmission after PE is common. African American race, Medicaid insurance, severity of illness, discharge status, and hospital region are significantly associated with readmission. The high readmission rates for venous thromboembolism and bleeding suggest that readmission may be linked to suboptimal quality of care in the management of PE.
Mots-clé
Acute Disease, African Continental Ancestry Group, Aged, Chest Pain, Female, Hemorrhage, Humans, Male, Medicaid, Multivariate Analysis, Neoplasms, Patient Compliance, Patient Readmission, Pennsylvania, Pneumonia, Pulmonary Embolism, Severity of Illness Index, Time Factors, United States, Venous Thromboembolism
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/04/2009 17:02
Dernière modification de la notice
20/08/2019 12:35
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