New respiratory research explores why patients admitted to hospital with community acquired pneumonia are at risk of being readmitted with the same condition within 30 days

New research into patients in England who are readmitted to hospital after admission with community acquired pneumonia (CAP) has been published today in Thorax, the International Respiratory and Critical Care Journal.

Pneumonia is a leading cause of death in the UK and worldwide, and emergency readmission to hospital within 30 days of discharge is a common measure of quality of care. During the period 2009-2019, The British Thoracic Society (BTS) national community-acquired pneumonia (CAP) audit reported decreased in-patient mortality (20.2%–10.4%) and improvement in the clinical management of adults hospitalised with CAP.

However, a trend towards increasing 30-day readmission rates among CAP survivors was also observed, increasing in the UK from 10.5% in 2009 to 14.3% in 2019. The drivers behind this trend were unclear, and the research sought to describe the cohort of patients and explore the reasons for their readmission.

Using data from the BTS national adult CAP audit linked to Hospital Episode Statistics data, the study compared those readmitted and primarily treated for pneumonia, with other diagnoses.

The research found that:

• Of 8136 cases who survived an index admission with CAP, 1304 (15.7%) were readmitted as an emergency within 30 days of discharge
• The main problems treated on readmission were pneumonia in 516 (39.6%) patients and other respiratory disorders in 284 (21.8%)
• Readmission with pneumonia compared with all other diagnoses was associated with significant inpatient mortality (15.9% vs 6.5%)
• A diagnosis of hospital-acquired infection was more frequent in readmissions treated for pneumonia than other diagnoses (22.1% vs 3.9%).

The co-author of the paper, Consultant Physician, Professor Wei Shen Lim, commented, “There has been a lot of attention given to improving care during the acute phase of illness with pneumonia. We now also need to pay attention to improving care during the recovery period, including measures to prevent readmissions or recurrences of pneumonia.“

The study concluded that pneumonia is the most common condition treated on readmission following hospitalisation with CAP and carries a higher mortality than both the index admission or from readmission due to other diagnoses. The authors recommend that strategies should be put in place to reduce readmissions and mortality in this patient group.

Read the research on the BTS website