scholarly journals Clinical characteristics and risk factors of preventable hospital readmissions within 30 days

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elsemieke A. I. M. Meurs ◽  
Carl E. H. Siegert ◽  
Elien Uitvlugt ◽  
Najla El Morabet ◽  
Ruth J. Stoffels ◽  
...  

AbstractKnowledge regarding preventable hospital readmissions is scarce. Our aim was to compare the clinical characteristics of potentially preventable readmissions (PPRs) with non-PPRs. Additionally, we aimed to identify risk factors for PPRs. Our study included readmissions within 30 days after discharge from 1 of 7 hospital departments. Preventability was assessed by multidisciplinary meetings. Characteristics of the readmissions were collected and 23 risk factors were analyzed. Of the 1120 readmissions, 125 (11%) were PPRs. PPRs occurred equally among different departments (p = 0.21). 29.6% of PPRs were readmitted by a practitioner of a different medical specialty than the initial admission (IA) specialist. The PPR group had more readmissions within 7 days (PPR 54% vs. non-PPR 44%, p = 0.03). The median LOS was 1 day longer for PPRs (p = 0.16). Factors associated with PPR were higher age (p = 0.004), higher socio-economic status (p = 0.049), fewer prior hospital admissions (p = 0.004), and no outpatient visit prior to readmission (p = 0.025). This study found that PPRs can occur at any department in the hospital. There is not a single type of patient that can easily be pinpointed to be at risk of a PPR, probably due to the multifactorial nature of PPRs.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miao Li ◽  
Xiao-Hua Han ◽  
Li-Yun Liu ◽  
Hui-Sheng Yao ◽  
Li-Li Yi

Abstract Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.


2019 ◽  
Vol 29 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Nabil Ahmed Badawy ◽  
Shokria Adely Labeeb ◽  
Mawaheb Falah Alsamdan ◽  
Badria Faleh Alazemi

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.


2018 ◽  
Vol 256 (5) ◽  
pp. 997-1003 ◽  
Author(s):  
An-Lun Wu ◽  
Lai-Chu See ◽  
Shao-Hsuan Hsia ◽  
Hui-Tzu Tu ◽  
Nan-Kai Wang ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Bich Diep Pham ◽  
Bao Giang Kim ◽  
Thi Thu Huyen Nguyen ◽  
Van Minh Hoang

Background. Providing messages on risk factors for noncommunicable diseases (NCDs) plays an important role in preventing disease. Objectives. This study investigated how often adults living in a rural area in northern Vietnam heard about risks factor for NCD and where they obtained that information. Methods. A cross-sectional survey was conducted using a multistage stratified cluster sampling to recruit 2970 participants. Data analyses were adjusted for all variables in a two-level multilevel Poisson regression model. Results. Overall, 77% of respondents had heard about NCDs, while 38.3 to 50% had been exposed to messages on risk factors of NCDs in the last month. Television, radio, and friends/neighbors were the most common sources of information. Most people exposed information no more than one or two sources. Factors associated with exposure to messages about risk were occupation, age group, education, and economic status. Conclusion. Intervention programs should focus on providing information primarily through television, considering influencing factors as well ensuring that messages reach target audiences.


Author(s):  
Rabi Prasad Regmi ◽  
Shyam Sundar Parajuly ◽  
Dela Singh ◽  
Nabin Shrestha ◽  
Srijana Sharma

Background: Stillbirth (SB) incidents are one of the most common adverse outcomes to occur during pregnancy. Studies indicate that approximately 3.3 million stillbirths are reported annually across the developing world. Institutional registration and under reporting of still birth to an authorized centre is a common problem. Objective: The objective of this study is to find out the incidence of SB after 28 weeks gestation and to find out the associated risk factors at Western Regional Hospital of Nepal. Materials and Methods: This is a cross sectional study carried out at Western Regional Hospital. Stillbirth babies born after 28 weeks of gestation or birth weight ≥ 1 kilogram and their mothers were recruited for the study. Intrapartum stillbirths were included despite of their ages, races or socio-economic status. Descriptive analysis was done on the data. Results: There were 3380 deliveries during the period of study. Among them, 50 cases were stillborn babies with a rate of 14 per thousand deliveries. The major risk factors associated were oligohydramnios, decreased fetal movement, growth restriction, meconium stained liquor and cord prolapse. Conclusion: Oligohydramnios (amniotic fluid index < 5cm) was the most common risk factor for stillbirth. Early identification and appropriate perinatal management could help to promote perinatal health.


2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 594.1-594
Author(s):  
B.S. Koo ◽  
Y.J. Kim ◽  
J.S. Oh ◽  
S. Hong ◽  
W.J. Seo ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rasel Kabir ◽  
Marwa Farag ◽  
Hyun Ja Lim ◽  
Nigatu Geda ◽  
Cindy Feng

Abstract Background Despite the substantial decline in child mortality globally over the last decade, reducing neonatal and under-five mortality in Bangladesh remains a challenge. Mothers who experienced multiple child losses could have substantial adverse personal and public health consequences. Hence, prevention of child loss would be extremely desirable during women’s reproductive years. The main objective of this study was to determine the risk factors associated with multiple under-five child loss from the same mother in Bangladesh. Methods In this study, a total of 15,877 eligible women who had given birth at least once were identified from the 2014 Bangladesh Demographic and Health Survey. A variety of count regression models were considered for identifying socio-demographic and environmental factors associated with multiple child loss measured as the number of lifetime under-five child mortality (U5M) experienced per woman. Results Of the total sample, approximately one-fifth (18.9%, n = 3003) of mothers experienced at least one child’s death during their reproductive period. The regression analysis results revealed that women in non-Muslim families, with smaller household sizes, with lower education, who were more advanced in their childbearing years, and from an unhygienic environment were at significantly higher risk of experiencing offspring mortality. This study also identified the J-shaped effect of age at first birth on the risk of U5M. Conclusions This study documented that low education, poor socio-economic status, extremely young or old age at first birth, and an unhygienic environment significantly contributed to U5M per mother. Therefore, improving women’s educational attainment and socio-economic status, prompting appropriate timing of pregnancy during reproductive life span, and increasing access to healthy sanitation are recommended as possible interventions for reducing under-five child mortality from a mother. Our findings point to the need for health policy decision-makers to target interventions for socio-economically vulnerable women in Bangladesh.


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