By Ethan Covey
Patients who are hospitalized with laboratory-confirmed influenza are much more likely to be readmitted than those with non-influenza?related problems.
Within 30 days, 14% of individuals hospitalized for influenza had at least one hospital readmission, a fact that may have important implications within a health care system working to prevent readmissions (J Infect Dis 2020 Mar 17. doi.org/10.1093/infdis/jiaa117).
“We know that influenza causes substantial morbidity and mortality, but we wanted to look into the characteristics of those patients who were readmitted,” said David Dobrzynski Jr., MD, the medical director of the antimicrobial stewardship program and the associate program director of the infectious diseases fellowship, Division of Infectious Diseases, University of Rochester Medical Center, in New York.
Dr. Dobrzynski and his team studied rates of hospital readmissions after laboratory-confirmed influenza hospitalizations in the middle Tennessee region. Data from the Tennessee Emerging Infections Program Influenza Surveillance project from 2006 to 2016 were analyzed, as were concurrent state Hospital Discharge Data System information.
Of nearly 3,000 patients with a hospitalization confirmed to be from influenza, 14% had at least a single readmission within 30 days, and 47% were readmitted within one year. Over half (54%) of the patient population had multiple readmissions.
Aside from influenza diagnosis, comorbidities played a significant role in readmissions. “When comparing those patients readmitted with those who were not readmitted after an influenza hospitalization, we found that patient comorbidities were associated with increased risk of readmission—specifically those with preexisting cardiovascular disease, lung disease, kidney disease, liver disease and immunosuppression,” Dr. Dobrzynski said.
In addition, age had a significant effect on readmission rates, with nearly half of readmissions consisting of patients aged 65 years and older. “As our population continues to age, this group will continue to be of more importance when focusing on readmissions,” Dr. Dobrzynski noted.
Future studies hopefully will be able to look at the effect of influenza vaccine usage on readmission rates, in patients with and without comorbidities.
Dr. Dobrzynski also noted that additional research could help elucidate whether influenza infection requiring hospitalization exacerbates an underlying illness, which leads to functional decline in the elderly population, or whether those who are already frail are predisposed to influenza infection and thus readmissions are more indicative of their frail state.
