Predictive Factors for 30-Day Readmissions in Elderly Patients With Pneumonia: A Single-Center Retrospective Cohort Study

Abstract

Background Pneumonia is a major concern among the elderly, with high readmission rates after hospitalization. These readmissions increase medical costs and reflect the quality of hospital care. This study aimed to explore the predictive factors associated with readmission within 30 days among elderly patients with pneumonia. Methodology This retrospective cohort study utilized the existing medical records. We included patients with pneumonia aged 75 and above who were discharged from a community hospital between April 2016 and March 2022. Patients who died during hospitalization or were transferred to other hospitals were excluded. Sex, age, length of hospital stay, Barthel Index (BI) at discharge, height, weight, body mass index, blood test findings, presence of tube feeding, Charlson Comorbidity Index, neutrophil-to-lymphocyte ratio (NLR), and Geriatric Nutritional Risk Index were used as predictive factors. The primary outcome was readmission within 30 days of discharge. A logistic regression analysis was performed. Results We included 337 patients: 50 (15%) in the readmission group and 287 (85%) in the control group. Univariate logistic regression analysis indicated low BI at discharge, and the odds ratio (OR) for readmission was 0.99 (95% confidence interval (CI) = 0.98-1.00). In patients with hemoglobin 10.0 g/dL or less, the OR for readmission was 2.18 (95% CI = 1.08-4.28). In patients with an NLR of 5 points or more, the OR for readmission was 2.64 (95% CI = 1.30 -5.24). In patients with aspartate transaminase of 38 U/L or more, the OR for readmission was 2.99 (95% CI = 1.07-7.68). Multivariate logistic regression revealed that an NLR of 5 points or more (adjusted OR = 2.42, 95% CI = 1.12-5.14) was correlated with readmission in elderly pneumonia patients. Conclusions In elderly patients with pneumonia, a high NLR at discharge may be a potential predictor of readmission within 30 days. This could be a new finding of our study. By sharing these findings during patient discharge conferences, there is potential to assist the medical team, patients, and caregivers in predicting unforeseen short-term readmissions. Further high-quality research is required to verify the reproducibility of these findings.