Risk factors for early hospital readmission in patients with AIDS and pneumonia.
OBJECTIVE
To determine risk factors for early readmission to the hospital in patients with AIDS and pneumonia.


METHODS
Case-control analysis.


METHODS
A municipal teaching hospital serving an indigent population.


METHODS
Case patients were all AIDS patients hospitalized with Pneumocystis carinii pneumonia or bacterial pneumonia between January 1992 and March 1995 who were readmitted for any nonelective reason within 2 weeks of discharge (n = 90). Control patients were randomly selected AIDS patients admitted during the study period who were not early readmissions (n = 87), matched by proportion of Pneumocystis carinii to bacterial pneumonia.


RESULTS
Demographics, social support, health-related behaviors, clinical aspects of the acute hospitalization, and general medical status were the main predictors measured.


RESULTS
Patients were at significantly increased risk of early readmission if they left the hospital unaccompanied by family or friend (odds ratio [OR] 4.76; 95% confidence interval [CI] 2.06, 11.0; p =.0003), used crack cocaine (OR 3.40; 95% CI 1.02, 11.3; p =. 046), had one or more coincident AIDS diagnoses (OR 3.65; 95% CI 1. 44, 9.26; p =.0065), or had been admitted in the preceding 6 months (OR 2.82; 95% CI 1.21, 6.57; p =.016). Demographic characteristics, alcoholism, intravenous drug use, illness severity on admission, and length of hospitalization did not predict early readmission.


CONCLUSIONS
Absence of companion at discharge and crack use were important risk factors for early readmission in patients with AIDS and pneumonia. Additional AIDS comorbidity and recent antecedent hospitalization were also risk factors; however, demographics and measures of acute illness during index hospitalization did not predict early readmission.
Grant
R W
RW
Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Charlebois
E D
ED
Wachter
R M
RM
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012919:Social Behavior