RF14 A systematic review of 30-day readmissions in adults hospitalised with community-acquired pneumonia
Notice bibliographique
Résumé
<h3>Background</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> 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, I<sup>2</sup>=98.95%. Only two subgroups analysis reported statistically significant differences (<i>p-value</i> <0.05). Retrospective studies had a higher readmission rate of 0.12 (95% CI 0.10 to 0.14, I<sup>2</sup>=99.39%) compared to prospective studies, 0.07 (95% CI 0.06 to 0.09, I<sup>2</sup>=93.35%). Europe had significantly lower 30-day readmission rate, 0.08 (95% CI 0.07 to 0.10, I<sup>2</sup>=94.98%) than North America, which reported 0.11 (95% CI 0.09 to 0.14, I<sup>2</sup>=99.50%). Non-pneumonia-related readmissions accounted for 0.60 (95% CI 0.48 to 0.72, I<sup>2</sup>=89.00%) of all 30-day readmissions. Additionally, 0.31 (95% CI 0.25 to 0.37, I<sup>2</sup>=79.74%) of 30-day readmissions were pneumonia-related, while 0.20 (95% CI 0.14 to 0.26, I<sup>2</sup>=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. <h3>Conclusion</h3> 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».