Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3787-3800
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3787
Risk factors for hospital readmissions in pneumonia patients: A systematic review and meta-analysis
Yuan-Yuan Fang, Jian-Chao Ni, Yin Wang, Jian-Hong Yu, Ling-Ling Fu
Yuan-Yuan Fang, Jian-Chao Ni, Jian-Hong Yu, Department of Geriatrics, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang Province, China
Yin Wang, Department of Internal Medicine, Yuecheng People’s Hospital, Shaoxing 312000, Zhejiang Province, China
Ling-Ling Fu, Department of Respiratory Medicine, Zhuji Affiliated Hospital of Shaoxing University, Zhuji 311800, Zhejiang Province, China
Author contributions: Fang YY and Ni JC conceived and designed the study; Wang Y and Yu JH were involved in literature search and data collection; Yu JH and Fu LL analyzed the data; Fang YY and Ni JC wrote the paper; Wang Y and Yu JH reviewed and edited the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and manuscript was prepared and revised according to the PRISMA 2020 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Ling Fu, MD, Chief Doctor, Department of Respiratory Medicine, Zhuji Affiliated Hospital of Shaoxing University, No. 9 Jianmin Road, Zhuji 311800, Zhejiang Province, China. fu198609262021@sina.com
Received: November 16, 2021
Peer-review started: November 16, 2021
First decision: January 11, 2022
Revised: January 25, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: April 26, 2022
Processing time: 156 Days and 11.1 Hours
Abstract
BACKGROUND

Factors that are associated with the short-term rehospitalization have been investigated previously in numerous studies. However, the majority of these studies have not produced any conclusive results because of their smaller sample sizes, differences in the definition of pneumonia, joint pooling of the in-hospital and post-discharge deaths and lower generalizability.

AIM

To estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia.

METHODS

Systematic search was conducted in PubMed Central, EMBASE, MEDLINE, Cochrane library, ScienceDirect and Google Scholar databases and search engines from inception until July 2021. We used the Newcastle Ottawa (NO) scale to assess the quality of published studies. A meta-analysis was carried out with random-effects model and reported pooled odds ratio (OR) with 95% confidence interval (CI).

RESULTS

In total, 17 studies with over 3 million participants were included. Majority of the studies had good to satisfactory quality as per NO scale. Male gender (pooled OR = 1.22; 95%CI: 1.16-1.27), cancer (pooled OR = 1.94; 95%CI: 1.61-2.34), heart failure (pooled OR = 1.28; 95%CI: 1.20-1.37), chronic respiratory disease (pooled OR = 1.37; 95%CI: 1.19-1.58), chronic kidney disease (pooled OR = 1.38; 95%CI: 1.23-1.54) and diabetes mellitus (pooled OR = 1.18; 95%CI: 1.08-1.28) had statistically significant association with the hospital readmission rate among pneumonia patients. Sensitivity analysis showed that there was no significant variation in the magnitude or direction of outcome, indicating lack of influence of a single study on the overall pooled estimate.

CONCLUSION

Male gender and specific chronic comorbid conditions were found to be significant risk factors for hospital readmission among pneumonia patients. These results may allow clinicians and policymakers to develop better intervention strategies for the patients.

Keywords: Hospital readmission; Meta-analysis; Pneumonia; Prediction; Systematic review

Core Tip: The main goal of this review is to estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia. In total, 17 studies with over 3 million participants were included. Most studies had good to satisfactory quality. Male gender and specific chronic comorbid conditions were found to be significant risk factors for hospital readmission among pneumonia patients. These results may allow clinicians and policymakers to develop better intervention strategies for the patients.