scholarly journals A ten-year retrospective study of unplanned hospital readmissions to a regional Australian hospital

2008 ◽  
Vol 32 (3) ◽  
pp. 537 ◽  
Author(s):  
Rick McLean ◽  
Kumara Mendis ◽  
Joe Canalese
Keyword(s):  
Average Length ◽  
Demographic Data ◽  
Hospital Readmissions ◽  
Temporal Variations ◽  
Early Spring ◽  
Late Winter ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Young Males ◽  
And Gender

Objective: To examine the trend in unplanned readmissions (URs) to Dubbo Base Hospital (DBH) over the period 1996-2005 and assess possible correlations with basic demographic data. Results: URs increased over the study period, both as a total number and as a proportion of total admissions (from 4.7 to 5.4%), while average length of stay decreased from 5.3 to 4.4 days and available hospital beds decreased from 156 to 116. The proportion of URs for people aged 75 years has more than doubled over the same period. There were clear temporal variations in URs (greatest number occurring on Fridays and in late winter/early spring) and variations with age and gender (greatest number in young males; peaks for males in 0-10 and 71-80-year deciles and for females in 0-10, 21-30 and 71-80 year deciles). Fifty percent of URs occurred within 7 days of discharge. There was a statistically significant but small correlation between length of prior admission and time to readmission (Spearman correlation coefficient, 0.068; P < 0.01) although the time to readmission did not change over the study period. Chronic obstructive pulmonary disease (3.8%), complications of procedures (3.6%), heart failure and pneumonia (each 2.2%), angina (2.1%) and acute bronchiolitis (1.8%) were the top causes of URs. Conclusion: URs are becoming more frequent in DBH; analysis of associations and trends over time are the first step in determining targeted measures to address the problem.

scholarly journals LINC01414/LINC00824 genetic polymorphisms in association with the susceptibility of chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoman Zhou ◽  
Yunjun Zhang ◽  
Yutian Zhang ◽  
Quanni Li ◽  
Mei Lin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Genetic Polymorphisms ◽  
Chronic Obstructive ◽  
Nucleotide Polymorphisms ◽  
Obstructive Pulmonary Disease ◽  
Logistic Analysis ◽  
Copd Patients ◽  
Increased Risk ◽  
And Gender

Abstract Objective Chronic obstructive pulmonary disease (COPD) is a complicated multi-factor, multi-gene disease. Here, we aimed to assess the association of genetic polymorphisms in LINC01414/ LINC00824 and interactions with COPD susceptibility. Methods Three single nucleotide polymorphisms (SNPs) in LINC01414/LINC00824 was genotyped by Agena MassARRAY platform among 315 COPD patients and 314 controls. Logistic analysis adjusted by age and gender were applied to estimate the genetic contribution of selected SNPs to COPD susceptibility. Results LINC01414 rs699467 (OR = 0.73, 95% CI 0.56–0.94, p = 0.015) and LINC00824 rs7815944 (OR = 0.56, 95% CI 0.31–0.99, p = 0.046) might be protective factors for COPD occurrence, while LINC01414 rs298207 (OR = 2.88, 95% CI 1.31–6.31, p = 0.008) risk-allele was related to the increased risk of COPD in the whole population. Rs7815944 was associated with the reduced risk of COPD in the subjects aged > 70 years (OR = 0.29, p = 0.005). Rs6994670 (OR = 0.57, p = 0.007) contribute to a reduced COPD risk, while rs298207 (OR = 7.94, p = 0.009) was related to a higher susceptibility to COPD at age ≤ 70 years. Rs298207 (OR = 2.54, p = 0.043) and rs7815944 (OR = 0.43, p = 0.028) variants was associated COPD risk among males. Rs7815944 (OR = 0.16, p = 0.031) was related to the reduced susceptibility of COPD in former smokers. Moreover, the association between rs298207 genotype and COPD patients with dyspnea was found (OR = 0.50, p = 0.016), and rs7815944 was related to COPD patients with wheezing (OR = 0.22, p = 0.008). Conclusion Our finding provided further insights into LINC01414/LINC00824 polymorphisms at risk of COPD occurrence and accumulated evidence for the genetic susceptibility of COPD.

scholarly journals Profile of patients admitted in a pulmonology ward and developing Clostridium difficile enterocolitis

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 31-36
Author(s):  
Ioana Cojocaru ◽  
Livia Luculescu ◽  
Daniela Negoescu ◽  
Irina Strâmbu
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Respiratory Infections ◽  
Demographic Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Male Predominance ◽  
Number Of Patients ◽  
Lower Intestine

Abstract Clostridium difficile is an anaerobic bacterium than can colonise the lower intestine and cause enterocolitis in susceptible patients. Clostridium difficile infection (CDI) is typically a nosocomial infection, favoured by treatment with antibiotics (especially with broad-spectrum drugs), proton pump inhibitors, but also comorbidities, old age and prolonged hospitalisation. Based on the observation that in the past years, the frequency of nosocomial CDI has increased in the Institute of Pulmonology, Bucharest, this retrospective observational study aimed to analyse the characteristics of admitted patients who develop CDI, in order to identify possible particular features and risk factors. Accordingly, medical files from 80 patients admitted from January 2015 to August 2017 were analysed for demographic data, respiratory diagnosis, comorbidities, blood tests, treatments prescribed, time of CDI onset, evolution and outcome. The number of patients studied was 29 in 2015, 16 in 2016 and 35 in 2017, with slight male predominance. Totally, 54 patients (67.5%) had tuberculosis (pulmonary or pleural), 12 had lung cancer, five had respiratory infections, two had chronic obstructive pulmonary disease and seven had other diseases. All patients but nine were receiving antibiotics: tuberculosis drugs, cephalosporins, fluoroquinolones and beta-lactams. About half of the patients received proton pump inhibitors. Most patients had several comorbidities. Mean time since admittance to onset of diarrhoea was 20 days. CDI was treated with metronidazole or vancomycin. The evolution was favourable in 90% of patients, but eight patients (10%) died This study highlights a high frequency of CDI in patients treated for tuberculosis. Due to insufficient data, no epidemiological consideration could be made. Further studies are needed to assess the relationship among tuberculosis, tuberculosis treatment and CDI.

Hospital Readmissions After Laboratory-Confirmed Influenza Hospitalization

2020 ◽  
Vol 222 (4) ◽  
pp. 583-589
Author(s):  
David M Dobrzynski ◽  
Danielle N Ndi ◽  
Yuwei Zhu ◽  
Tiffanie Markus ◽  
William Schaffner ◽  
...  
Keyword(s):  
Influenza Infection ◽  
Hospital Readmissions ◽  
Influenza Surveillance ◽  
Chronic Obstructive ◽  
Emerging Infections ◽  
Obstructive Pulmonary Disease ◽  
Discharge Data ◽  
Increased Risk ◽  
Common Causes ◽  
Substantial Morbidity

Abstract Background Influenza infection causes substantial morbidity and mortality. However, little is known about hospital readmissions after an influenza hospitalization. The aim of our study was to characterize frequency of hospital readmissions among patients hospitalized with laboratory-confirmed influenza. Methods We conducted a retrospective study using Tennessee Emerging Infections Program Influenza Surveillance data from 2006 to 2016 and the concurrent Tennessee Hospital Discharge Data System. We analyzed demographic characteristics and outcomes to better understand frequency and factors associated with hospital readmissions. Results Of the 2897 patients with a laboratory-confirmed influenza hospitalization, 409 (14%) and 1364 (47%) had at least 1 hospital readmission within 30 days and 1 year of the influenza hospitalization, respectively. Multiple readmissions occurred in 739 patients (54%). The readmission group was older, female predominant, and had more comorbidities than patients not hospitalized. Pneumonia, acute chronic obstructive pulmonary disease/asthma exacerbation, septicemia, acute respiratory failure, and acute renal failure were the most common causes for readmission at 30 days. Underlying cardiovascular disease, lung disease, kidney disease, diabetes, immunosuppression, and liver disease were associated with increased risk of readmission during the subsequent year. Conclusions After an admission with laboratory-confirmed influenza, there is a high likelihood of readmission within 30 days and 1 year adding to the morbidity of influenza.

scholarly journals Ability of the LACE index to predict 30-day hospital readmissions in patients with community-acquired pneumonia

2020 ◽  
Vol 6 (2) ◽  
pp. 00301-2019
Author(s):  
Claudia C. Dobler ◽  
Maryam Hakim ◽  
Sidhartha Singh ◽  
Matthew Jennings ◽  
Grant Waterer ◽  
...  
Keyword(s):  
Prediction Models ◽  
Hospital Readmissions ◽  
Predictive Ability ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Day Hospital ◽  
Discriminative Ability ◽  
Obstructive Pulmonary Disease ◽  
C Statistic

Background and objectiveHospital readmissions within 30 days are used as an indicator of quality of hospital care. We aimed to evaluate the ability of the LACE (Length of stay, Acuity of admission, Comorbidities based on Charlson comorbidity score and number of Emergency visits in the last 6 months) index to predict the risk of 30-day readmissions in patients hospitalised for community-acquired pneumonia (CAP).MethodsIn this retrospective cohort study a LACE index score was calculated for patients with a principal diagnosis of CAP admitted to a tertiary hospital in Sydney, Australia. The predictive ability of the LACE score for 30-day readmissions was assessed using receiver operator characteristic curves with C-statistic.ResultsOf 3996 patients admitted to hospital for CAP at least once, 8.0% (n=327) died in hospital and 14.6% (n=584) were readmitted within 30 days. 17.8% (113 of 636) of all 30-day readmissions were again due to CAP, followed by readmissions for chronic obstructive pulmonary disease, heart failure and chest pain. The LACE index had moderate discriminative ability to predict 30-day readmission (C-statistic=0.6395) but performed poorly for the prediction of 30-day readmissions due to CAP (C-statistic=0.5760).ConclusionsThe ability of the LACE index to predict all-cause 30-day hospital readmissions is comparable to more complex pneumonia-specific indices with moderate discrimination. For the prediction of 30-day readmissions due to CAP, the performance of the LACE index and modified risk prediction models using readily available variables (sex, age, specific comorbidities, after-hours, weekend, winter or summer admission) is insufficient.

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