PT - JOURNAL ARTICLE AU - Klukowska, AM AU - Lim, WS AU - McKeever, T AU - Pick, H AU - Ashton, D TI - RF14 A systematic review of 30-day readmissions in adults hospitalised with community-acquired pneumonia AID - 10.1136/jech-2018-SSMabstracts.103 DP - 2018 Sep 01 TA - Journal of Epidemiology and Community Health PG - A50--A50 VI - 72 IP - Suppl 1 4099 - http://jech.bmj.com/content/72/Suppl_1/A50.1.short 4100 - http://jech.bmj.com/content/72/Suppl_1/A50.1.full SO - J Epidemiol Community Health2018 Sep 01; 72 AB - Background Community-acquired pneumonia (CAP) is one of the most common communicable diseases worldwide associated with significant levels of morbidity and mortality causing a substantial economic burden. 30-day hospital readmission rate is often used as a secondary outcome in studies of CAP. This data can be used to define the burden of disease and the reasons for readmissions potentially amenable to intervention.A systematic review and random meta-analysis were conducted to estimate the pooled 30-day readmission rate of adult patients with CAP and 30-day pneumonia-related/non-pneumonia-related and cardiovascular-related readmission rates of such patients.Methods MEDLINE, EMBASE, AMED (until October 2017) and reference lists of papers were searched to identify studies of CAP including 30-day hospital readmission rate of adult patients. Each step of the study selection process was conducted by two independent reviewers. The quality was assessed using a pre-tested form based on the Newcastle-Ottawa Scale. Pooled proportions of patients readmitted within 30 days with 95% confidence intervals (CI), were estimated. Additional subgroup analyses were conducted.Results A total of 63 studies were included in the statistical analysis, covering the period from 1994 to 2017. The pooled 30-day readmission rate estimate was 0.10 (CI 0.08–0.11). High levels of heterogeneity were identified, I2=98.95%. Only two subgroups analysis reported statistically significant differences (p-value <0.05). Retrospective studies had a higher readmission rate of 0.12 (95% CI 0.10 to 0.14, I2=99.39%) compared to prospective studies, 0.07 (95% CI 0.06 to 0.09, I2=93.35%). Europe had significantly lower 30-day readmission rate, 0.08 (95% CI 0.07 to 0.10, I2=94.98%) than North America, which reported 0.11 (95% CI 0.09 to 0.14, I2=99.50%). Non-pneumonia-related readmissions accounted for 0.60 (95% CI 0.48 to 0.72, I2=89.00%) of all 30-day readmissions. Additionally, 0.31 (95% CI 0.25 to 0.37, I2=79.74%) of 30-day readmissions were pneumonia-related, while 0.20 (95% CI 0.14 to 0.26, I2=33.55%) were cardiovascular-related. The studied populations were mostly composed of elderly patients. High levels of heterogeneity may have been due to different selection criteria of included studies and variations among health-care systems and treatment practices.Conclusion Among all adult patients with CAP, 10% are readmitted to the hospital within 30 days. The majority of all-cause readmissions are non-pneumonia-related, specifically 20% are cardiovascular related. Only one third of 30-day readmissions are due to pneumonia.