ED Discharge with Pneumonia: Factors Associated with ED Return and Inpatient Admission

• Activity Number: 642
• Type: Contributed
• Date/Time: Thursday, August 7, 2014 : 10:30 AM to 12:20 PM
• Sponsor: IMS
• Author(s): Zehua Liu*+ and Shunsuke Ito and Madeline Vossbrinck and Raymond Gregory and Van Dunn and Ronald B. Low
• Companies: HHC and HHC and HHC and HHC and HHC and HHC
• Keywords: Pneumonia ; Medication ; Hypertension ; Readmission

Abstract

Objectives: To identify factors which put ED patients at increased risk for failing outpatient pneumonia therapy.

Methods: Logistic regression models are used to model the odds that a patient was discharged from the ED with a pneumonia diagnosis, and readmitted as an inpatient within 30 days. Possible covariates considered are age, a prior suspected co-morbidity (asthma, COPD, hypertension, etc.) and medication (beta blocker, beta agonist, ARBs, ACE inhibitors, etc.). Inclusion criteria included: p-value, AIC and Goodness-of-Fit test.

Results: Among 2967 patients, 2851 were not admitted as an inpatient after an ED discharge; 116 were admitted at least once. Medications were found to have significant relationship to ED readmission, include: beta blocker, beta agonist, ARB, diuretics and Ca channel blockers. Gender, age, and co-morbidities did not have a significant relationship. AUC of the final model is .643.

Conclusions: In this population of ED pneumonia patients discharged home, most medications used to treat asthma and hypertension were associated with increased odds of return and inpatient admission.