Associations between biomarkers at discharge and co-morbidities and risk of readmission after community-acquired pneumonia: a retrospective cohort study
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Associations between biomarkers at discharge and co-morbidities and risk of readmission after community-acquired pneumonia : a retrospective cohort study. / Petersen, Pelle Trier; Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Pedersen, Merete Frejstrup; Rohde, Gernot; Ravn, Pernille.
In: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, Vol. 37, No. 6, 2018, p. 1103-1111.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Associations between biomarkers at discharge and co-morbidities and risk of readmission after community-acquired pneumonia
T2 - a retrospective cohort study
AU - Petersen, Pelle Trier
AU - Egelund, Gertrud Baunbæk
AU - Jensen, Andreas Vestergaard
AU - Andersen, Stine Bang
AU - Pedersen, Merete Frejstrup
AU - Rohde, Gernot
AU - Ravn, Pernille
PY - 2018
Y1 - 2018
N2 - To investigate whether hemoglobin, white blood cell count (WBC), urea, sodium, albumin, and C-reactive protein at discharge in patients hospitalized for community-acquired pneumonia (CAP) are associated with 30-day readmission. This study is a retrospective cohort study, which included all adult patients discharged after hospitalization for CAP from three Danish hospitals between January 2011 and July 2012. The outcome was all-cause, unplanned, 30-day readmission. Biomarker concentrations at discharge were transformed into binary variables by using either upper or lower quartiles as cut-off; the upper quartile was used for WBC, urea, and C-reactive protein, and the lower quartile was used for hemoglobin, sodium, and albumin. The study population consisted of 1149 patients. One hundred eighty-four (16.0%) patients were readmitted. Independent risk factors of readmission were WBC ≥ 10.6 cells × 109/L (hazard ratio 1.50; 95% CI, 1.07-2.11) and albumin <32 g/L (hazard ratio 1.78; 95% CI, 1.24-2.54) at discharge and the presence of ≥ 2 co-morbidities (hazard ratio 1.74; 95% CI, 1.15-2.64). When WBC, albumin, and co-morbidities were combined into a risk-stratification tool, there was a step-wise increase in risk of readmission for patients with 1, 2, or 3 risk factors with hazard ratios of 1.76 (95% CI, 1.25-2.49), 2.59 (95% CI, 1.71-3.93), and 6.15 (95% CI 3.33-11.38), respectively. WBC ≥ 10.6 cells × 109/L and albumin < 32 g/L at discharge and the presence of ≥ 2 co-morbidities were independently associated with increased risk of 30-day readmission.
AB - To investigate whether hemoglobin, white blood cell count (WBC), urea, sodium, albumin, and C-reactive protein at discharge in patients hospitalized for community-acquired pneumonia (CAP) are associated with 30-day readmission. This study is a retrospective cohort study, which included all adult patients discharged after hospitalization for CAP from three Danish hospitals between January 2011 and July 2012. The outcome was all-cause, unplanned, 30-day readmission. Biomarker concentrations at discharge were transformed into binary variables by using either upper or lower quartiles as cut-off; the upper quartile was used for WBC, urea, and C-reactive protein, and the lower quartile was used for hemoglobin, sodium, and albumin. The study population consisted of 1149 patients. One hundred eighty-four (16.0%) patients were readmitted. Independent risk factors of readmission were WBC ≥ 10.6 cells × 109/L (hazard ratio 1.50; 95% CI, 1.07-2.11) and albumin <32 g/L (hazard ratio 1.78; 95% CI, 1.24-2.54) at discharge and the presence of ≥ 2 co-morbidities (hazard ratio 1.74; 95% CI, 1.15-2.64). When WBC, albumin, and co-morbidities were combined into a risk-stratification tool, there was a step-wise increase in risk of readmission for patients with 1, 2, or 3 risk factors with hazard ratios of 1.76 (95% CI, 1.25-2.49), 2.59 (95% CI, 1.71-3.93), and 6.15 (95% CI 3.33-11.38), respectively. WBC ≥ 10.6 cells × 109/L and albumin < 32 g/L at discharge and the presence of ≥ 2 co-morbidities were independently associated with increased risk of 30-day readmission.
KW - Aged
KW - Aged, 80 and over
KW - Biomarkers/analysis
KW - Blood Cell Count
KW - C-Reactive Protein/analysis
KW - Cohort Studies
KW - Community-Acquired Infections/diagnosis
KW - Female
KW - Hospitalization
KW - Humans
KW - Male
KW - Middle Aged
KW - Patient Discharge
KW - Patient Outcome Assessment
KW - Patient Readmission
KW - Pneumonia/diagnosis
KW - Retrospective Studies
KW - Serum Albumin/analysis
KW - Urea/analysis
U2 - 10.1007/s10096-018-3224-8
DO - 10.1007/s10096-018-3224-8
M3 - Journal article
C2 - 29600325
VL - 37
SP - 1103
EP - 1111
JO - European Journal of Clinical Microbiology & Infectious Diseases
JF - European Journal of Clinical Microbiology & Infectious Diseases
SN - 0934-9723
IS - 6
ER -
ID: 214397912