Risk factors for early hospital readmission in patients with AIDS and pneumonia

OBJECTIVE: To determine risk factors for early readmission to the hospital in patients with AIDS and pneumonia. DESIGN: Case-control analysis. SETTING: A municipal teaching hospital serving an indigent population. PATIENTS: Case patients were all AIDS patients hospitalized with Pneumocyst is carinii pneumonia or bacterial pneumonia between January 1992 and March 1995 who were readmitted for any nonelective reason within 2 weeks of disch arge (n = 90). Control patients were randomly selected AIDS patients admitt ed during the study period who were not early readmissions (n. = 87), match ed by proportion of Pneumocystis carinii to bacterial pneumonia. MEASUREMENTS AND MAIN RESULTS: Demographics, social support, health-related behaviors, clinical aspects of the acute hospitalization, and general medi cal status were the main predictors measured. RESULTS: Patients were at significantly increased risk of early readmission if they left the hospital unaccompanied by family or friend (odds ratio [O R] 4.76; 95% confidence interval [CI] 2.06, 11.0; p = .0003), used crack co caine (OR 3.40; 95% CI 1.02, 11.3; p = .046), had one or more coincident AI DS diagnoses (OR 3.65; 95% CI 1.44, 9.26; p = .0065), or had been admitted in the preceding 6 months (OR 2.82; 95% CI 1.21, 6.57; p = .016). Demograph ic characteristics, alcoholism, intravenous drug use, illness severity on a dmission, and length of hospitalization did not predict early readmission. CONCLUSIONS: Absence of companion at discharge and crack use were important risk factors for early readmission in patients with AIDS and pneumonia. Ad ditional AIDS comorbidity and recent antecedent hospitalization were also r isk factors; however. demographics and measures of acute illness during ind ex hospitalization did not predict early readmission.