Predictors of Length of Stay, Rehospitalization and Mortality in Community-Acquired Pneumonia Patients: A Retrospective Cohort Study

Giorgia Lüthi-Corridori; Maria Boesing; Andrea Roth; Stéphanie Giezendanner; Anne Barbara Leuppi-Taegtmeyer; Philipp Schuetz; Joerg D Leuppi

doi:10.3390/jcm12175601

Predictors of Length of Stay, Rehospitalization and Mortality in Community-Acquired Pneumonia Patients: A Retrospective Cohort Study

J Clin Med. 2023 Aug 28;12(17):5601. doi: 10.3390/jcm12175601.

Authors

Giorgia Lüthi-Corridori^{1

2}, Maria Boesing^{1

2}, Andrea Roth^{1

2}, Stéphanie Giezendanner^{1

2}, Anne Barbara Leuppi-Taegtmeyer^{1

2

3}, Philipp Schuetz^{2

4}, Joerg D Leuppi^{1

2}

Affiliations

¹ University Centre of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland.
² Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland.
³ Department of Patient Safety, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
⁴ Cantonal Hospital Aarau, University Department of Medicine, Tellstrasse 25, 5001 Aarau, Switzerland.

Abstract

Background: Community-acquired pneumonia (CAP) represents one of the leading causes of hospitalization and has a substantial impact on the financial burden of healthcare. The aim of this study was to identify factors associated with the length of hospital stay (LOHS), rehospitalization and mortality of patients admitted for CAP.

Methods: A retrospective cohort study was conducted with patients presenting to a Swiss public hospital between January 2019 and December 2019. Zero-truncated negative binomial and multivariable logistic regression analyses were performed to assess risk factors.

Results: A total of 300 patients were analyzed (median 78 years, IQR [67.56, 85.50] and 53% males) with an average LOHS of 7 days (IQR [5.00, 9.00]). Of the 300 patients, 31.6% (97/300) were re-hospitalized within 6 months, 2.7% (8/300) died within 30 days and 11.7% (35/300) died within 1 year. The results showed that sex (IRR = 0.877, 95% CI = 0.776-0.992, p-value = 0.036), age (IRR = 1.007, 95% CI = 1.002-1.012, p-value = 0.003), qSOFA score (IRR = 1.143, 95% CI = 1.049-1.246, p-value = 0.002) and atypical pneumonia (IRR = 1.357, 95% CI = 1.012-1.819, p-value = 0.04) were predictive of LOHS. Diabetes (OR = 2.149, 95% CI = 1.104-4.172, p-value = 0.024), a higher qSOFA score (OR = 1.958, 95% CI = 1.295-3.002, p-value = 0.002) and rehabilitation after discharge (OR = 2.222, 95% CI = 1.017-4.855, p-value = 0.044) were associated with a higher chance of being re-hospitalized within 6 months, whereas mortality within 30 days and within one year were both associated with older age (OR = 1.248, 95% CI = 1.056-1.562, p-value = 0.026 and OR = 1.073, 95% CI = 1.025-1.132, p-value = 0.005, respectively) and the presence of a cancer diagnosis (OR = 32.671, 95% CI = 4.787-369.1, p-value = 0.001 and OR = 4.408, 95% CI = 1.680-11.43, p-value = 0.002, respectively).

Conclusion: This study identified routinely available predictors for LOHS, rehospitalization and mortality in patients with CAP, which may further advance our understanding of CAP and thereby improve patient management, discharge planning and hospital costs.

Keywords: CAP; LOHS; community-acquired pneumonia; length of hospital stay; mortality; prediction; rehospitalization.

Grants and funding

2018DRI08)/Swiss Personalized Health Network (SPHN)