Abstract:
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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.
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