Early unplanned readmission of patients with newly diagnosed tuberculosis discharged from acute hospital to ambulatory treatment.
OBJECTIVE
The aim of this study was to examine whether patients with newly diagnosed tuberculosis (TB) discharged to ambulatory treatment are at risk of unplanned readmission through the emergency department within 28 days of discharge, and the risk factors associated with such readmission.


METHODS
A cohort of 134 patients admitted to an acute medical department with TB, who were subsequently discharged to ambulatory treatment of TB, were studied by a retrospective record review for unplanned readmission in 28 days. Potential risk factors associated with the readmission were recorded during hospital stay and follow-up visits, including age, sex, length of stay, substance abuse, need of assistance in the activities of daily living (ADL), comorbidities, non-compliance, drug complications and use of non-standard drug regimen.


RESULTS
Up to 20.1% of patients were readmitted. Factors independently associated with early unplanned readmission were need of assistance in ADL, drug complications, the need to use a non-standard drug regimen and more than three non-chest comorbidities.


CONCLUSIONS
A significant readmission rate was found in these patients and potential risk factors were identified. Ambulatory treatment for TB may not be appropriate for selected patients. Local guidelines for the management of TB patients at high risk of readmission is needed.
Chu
C M
CM
Divisions of Respiratory Medicine, Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong SAR, China. nncmchu@netvigator.com
Yung
C Y
CY
Leung
W S
WS
Chan
V L
VL
Leung
E M
EM
D000203:Activities of Daily Living; D000368:Aged; D000554:Ambulatory Care Facilities; D015984:Causality; D015331:Cohort Studies; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013997:Time Factors; D014376:Tuberculosis / Q000503:physiopathology*