Hospital Readmission and Mortality in a Brazilian Tertiary Public Hospital
Hospital Readmission and Mortality in a Brazilian Tertiary Public Hospital
复制标题
巴西三级公立医院的再入院率和死亡率
DOI：
10.1097/qmh.0000000000000253
复制
发表时间：
2020
影响因子：
1.2
通讯作者：
F. Pivatto Júnior
中科院分区：
文献类型：
--
作者：
Augusto Berton Bettiol;André Wajner;F. Pivatto Júnior
背景和目的：关于再入院相关死亡率的数据是不精确的，而且变化很大。本研究旨在描述巴西三级公立医院内科出院患者的非选择性30天再入院率和相关的住院死亡率。研究方法：这项回顾性队列研究纳入了2017年9月至11月期间从我们机构内科出院并在30天内非选择性再次入院的所有患者。结果：共分析了1047例出院病例。非选择性30天再入院率为13.7%。其中，41例（28.5%）为早期再入院（0 - 7天），103例（71.5%）为晚期再入院（8 - 30天）。再入院期间的住院死亡率为27.8%，早期再入院期间的住院死亡率显著更高（41.5% vs 22.3%; P = 0.035）。与年龄和Charlson合并症指数无关，早期（与晚期相比）再入院与再入院期间的死亡率相关（相对危险度[RR] 1.95; 95%置信区间，1.18 - 3.22; P =.002）。结论：再入院率为13.7%，相关死亡率为27.8%。与晚期再入院相比，早期再入院是死亡率的独立预测因子（RR 1.95）。需要更大规模的研究来更好地识别这组患者，以便采取预防措施。
Background and Objectives: Data on mortality associated with hospital readmission are imprecise and highly variable. This study aimed to describe the rate of nonelective 30-day readmission and associated hospital mortality of patients discharged from the Internal Medicine Unit of a Brazilian tertiary public hospital. Methods: This retrospective cohort study included all patients discharged from the Internal Medicine Unit of our institution between September and November 2017 who were nonelectively readmitted within 30 days. Results: A total of 1047 hospital discharges were analyzed. The rate of nonelective 30-day readmission was 13.7%. Of these, 41 (28.5%) were early readmissions (0-7 days) and 103 (71.5%) were late readmissions (8-30 days). The hospital mortality rate during readmission was 27.8%, being significantly higher during early readmissions (41.5% vs 22.3%; P = .035). Early (as compared with late) readmission was associated with mortality during readmission (relative risk [RR] 1.95; 95% confidence interval, 1.18-3.22; P = .002), regardless of age and Charlson comorbidity index. Conclusion: The Readmission rate was 13.7%, with an associated mortality of 27.8%. Early readmission was an independent predictor of mortality (RR 1.95) in relation to late readmission. Larger studies are needed to better identify this group of patients with an aim to adopt preventive measures.