Predictors of Allison et al for 30-Day Readmission for a Patient Discharged with Ongoing Outpatient Parenteral Antibiotic Therapy (OPAT)

Description

Allison et al identified patients receiving outpatient parenteral antibiotics after discharge who are more likely to be readmitted. Any patient receiving outpatient parenteral antibiotic therapy (OPAT) is at increased risk for 30-day readmission. The authors are from Tufts Medical Center, University Hospital of South Manchester (England) and Biogen Idec (Cambridge, Massachusetts).

Patient selection: outpatient parenteral antibiotic therapy (OPAT)

Outcome: 30-day readmission

The lowest quintile had a 30-day readmission rate of 17% vs 43% for highest quintile.

Reasons for readmission:

(1) worsening infection

(2) new infection

(3) comorbid condition (unrelated to infection)

(4) adverse drug reaction

(5) complication involving the intravenous catheter

(6) diarrhea (Clostridium difficile, other)

Risk factors for 30-day readmission:

(1) advanced age (odds ratio 1.09 per 10 years, will use >= 60 years as risk factor)

(2) therapy with an aminoglycoside (odds ratio 2.3)

(3) resistant organism (odds ratio 1.6)

(4) number of prior hospital discharges without IV antibiotics in the past 12 months (odds ratio 1.2 per admission, will use >= 3 as risk factor)

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The risk of readmission increases with the number of risk factors.

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