Risk factors for hospital readmissions in pneumonia patients: A systematic review and meta-analysis

摘要

BACKGROUND Factors that are associated with the short-term rehospitalization have been investigated previously in numerous studies.However,the majority of these studies have not produced any conclusive results because of their smaller sample sizes,differences in the definition of pneumonia,joint pooling of the in-hospital and post-discharge deaths and lower generalizability.AIM To estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia.METHODS Systematic search was conducted in PubMed Central,EMBASE,MEDLINE,Cochrane library,ScienceDirect and Google Scholar databases and search engines from inception until July 2021.We used the Newcastle Ottawa(NO)scale to assess the quality of published studies.A meta-analysis was carried out with random-effects model and reported pooled odds ratio(OR)with 95%confidence interval(CI).RESULTS In total,17 studies with over 3 million participants were included.Majority of the studies had good to satisfactory quality as per NO scale.Male gender(pooled OR=1.22;95%CI:1.16-1.27),cancer(pooled OR=1.94;95%CI:1.61-2.34),heart failure(pooled OR=1.28;95%CI:1.20-1.37),chronic respiratory disease(pooled OR=1.37;95%CI:1.19-1.58),chronic kidney disease(pooled OR=1.38;95%CI:1.23- 1.54) and diabetes mellitus (pooled OR = 1.18;95%CI: 1.08-1.28) had statistically significantassociation with the hospital readmission rate among pneumonia patients. Sensitivity analysisshowed that there was no significant variation in the magnitude or direction of outcome,indicating lack of influence of a single study on the overall pooled estimate.CONCLUSIONMale gender and specific chronic comorbid conditions were found to be significant risk factors forhospital readmission among pneumonia patients. These results may allow clinicians and policymakersto develop better intervention strategies for the patients.