Risk factor for 31-day unplanned readmission to hospital in patients with pulmonary tuberculosis in China

Abstract

Objectives: To evaluate risk factors associated with 31-day unplanned readmission(s) for pulmonary tuberculosis (TB) in China.Methods: This retrospective study enrolled patients (age, >14 years) with pulmonary TB who experienced 31-day unplanned readmissions to a specialized hospital for TB between January 2018 and December 2019. For each confirmed readmission, 2 control subjects were randomly selected from among patients with pulmonary Original Article TB but did not experience an unplanned readmission within 31 days.Results: A total of 402 pulmonary TB patients (5.9%) experienced unplanned readmission within 31 days after discharge. In univariate analysis, readmission was associated with gender, age, insurance coverage, residing in a rural area, active smoking, chronic obstructive pulmonary disease (COPD), drug-induced hepatitis, and leaving hospital against medical advice. The final logistic regression model revealed that higher risks for unplanned readmissions were associated with male gender (odds ratio [OR] 1.44, [95% confidence interval (CI) : 1.06-1.95]), age >65 years (OR 2.94, 95%CI: 2.03-4.27), rural residence (OR 8.86, 95%CI: 6.61-11.87), active smoking (OR 2.15, 95% CI 1.37-3.40), COPD (OR 2.77, 95%CI: 1.59-4.81), and leaving hospital against physician advice (OR 4.11,). The median time to 31-day unplanned readmission was 24 days. Major reasons for unplanned readmission included fever, exacerbation of dyspnea, and hemoptysis. Conclusion:Unplanned readmission for pulmonary TB within 31 days of discharge was higher among older males residing in rural areas, active smokers, and those leaving hospital against medical advice.

Incidence, causes, and risk factors for unplanned readmission in patients admitted with pulmonary tuberculosis in China

“…This study was a retrospective study on patients with recurrent pulmonary TB. In this research, the rate of unplanned readmission of patients with pulmonary TB within 30 days after discharge was 5.2%, lower than that reported by Jing et al (5.91%) [17]. The present study showed significant associations among unplanned readmissions in terms of gender, age, place of residence, smoking, COPD, viral hepatitis, drug abuse, non-standard treatment, adverse drug reactions, and noncompliance with hospital discharge.…”

Is Tobacco Use Associated With Risk of Recurrence and Mortality Among People With TB?

“…For treatment nonadherence, effect measures were extracted from seven of eight included studies, 33 , 77 , 82 , 113 , 116 , 133 , 135 , 136 all reporting increased risk associated with tobacco use, and one also reporting increased risk associated with ST use. 77 Disease severity was indicated by risk of hospitalization or cavitation in five included studies, 32 , 126 , 128 , 130 , 143 and all reported increased risk with tobacco use. Finally, one case-control study reported an increased risk of drug resistance developing with tobacco use compared with no tobacco use.…”

Aetiologies and Risk Factors of Prolonged Fever Admission in Samtse Hospital, Bhutan, 2020

“…In the present study, the prolonged hospital stay was higher among people living in rural areas than those living in urban areas. Other studies have shown people living in rural areas are more prone to infections, adverse health outcomes and higher admission rates due to a lack of awareness of disease prevention [25], poverty, poor socioeconomic and poor dietary habits [26]. This could be true in Bhutan because the rural population has fewer resources to obtain health education.…”