P184 Readmissions and mortality following index hospitalisation for community-acquired pneumonia: a population-based analysis using HES data

Introduction: Hospital readmission following an index admission for community-acquired pneumonia (CAP) remains a significant clinical and healthcare burden in the UK, with the BTS Pneumonia audit reporting rates of 16%.1 However, limited data exists on risk factors and outcomes associated with readmission. This study characterises patient and disease features linked to readmission following a CAP admission in a large extract of Hospital Episode Statistics (HES) data (Health and Social Care Information Centre).2

Methods: HES data were used to identify adults (≥18 years) admitted to English hospitals with a diagnosis code of pneumonia (J12-J18) in 2018. Patients who died during their index admission were excluded. All-cause readmission and in-hospital mortality within 90 days post-discharge was assessed. Baseline demographics and comorbidities were described.

Results :Of 227,213 patients (85%) surviving an index CAP admission, 67,536 (30%) were readmitted within 90 days. The median time from CAP diagnosis date to readmission was 31 days [IQR 17–53] (figure 1). The median readmission stay was 2 days [IQR 0–9].

Baseline characteristics were broadly similar between readmitted and non-readmitted patients (mean age 72 vs. 71 years, males 52% vs. 49% respectively). Minor differences in comorbidities were observed: IHD (25% vs. 20%), diabetes (24% vs. 21%), PVD (7% vs. 5%), hypertension (50% vs. 46%) and COPD (10% vs. 6%). Readmitted patients had a marginally longer index stay (median=7 days, IQR 3–13) than non-readmitted patients (median=6 days, IQR 3–15). In-hospital mortality among readmitted patients was 10%.

Conclusion: Patients hospitalised with CAP are at increased risk of readmission within 90 days, affecting nearly one in three surviving an index admission. Readmission risk appears difficult to predict from comorbidity or demographics. Given the substantial mortality risk in this cohort, reducing readmission should be a key focus in post-discharge care for CAP patients. Moving forward, we plan to describe trends in readmission and the impact of frailty.