730. Hospital Readmissions following Laboratory-confirmed Influenza
Session: Poster Abstract Session: Respiratory Infections: Viral
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • D Dobrzynski Flu IDSA Final.pdf (1.4 MB)
  • Background: Further understanding of hospital readmissions after influenza illness could reduce readmissions. The aim of our study was to characterize the morbidity associated with laboratory confirmed influenza hospitalizations.

    Methods: This was a retrospective study using data from 2006-2016 from the Tennessee (TN) Emerging Infections Program Influenza Surveillance Network, which prospectively identifies laboratory-confirmed influenza hospitalizations in Nashville, TN and surrounding counties. Using the TN Hospital Discharge Data System, which collects information on all hospitalizations and discharges in TN, cases were linked to subsequent hospitalizations up to one year. The International Classification of Diseases was used to define the primary diagnosis associated with each hospitalization. Demographic characteristics and outcomes were compared by using χ2 tests for categorical variables. Multivariable logistic regression was used to compare study outcomes.

    Results: Of the 2897 patients with a laboratory-confirmed influenza hospitalization, 1364 (47%) had a hospital readmission during the subsequent year (Figure). Multiple readmissions occurred in 740 patients (54%). The readmission group was older, female predominant, and had more comorbidities than patients not re-hospitalized. Acute COPD/asthma exacerbation, pneumonia, septicemia, and acute renal failure were the most common causes for readmission. Underlying cardiovascular disease (OR 1.6), lung disease (OR 1.6), kidney disease (OR 1.7), diabetes (OR 1.3), immunosuppression (OR 1.6), and liver disease (OR 2.1) were associated with increased risk of readmission (Table).

    Conclusion: An influenza hospitalization is associated with increased hospital readmissions. Approximately 47% of patients hospitalized with influenza are readmitted within one year. Patient comorbidities could be an important link to influenza readmissions.

    Table-Multivariable Analysis of Hospital Readmission

    OR

    P

    Age

    0.7

    P=0.039

    Male

    0.8

    P=0.012

    CVD

    1.6

    P<0.001

    Stroke

    1.1

    P=0.391

    Diabetes

    1.3

    P=0.017

    Lung Disease

    1.6

    P<0.001

    Kidney Disease

    1.7

    P<0.001

    Immunosuppression

    1.6

    P<0.001

    Dementia

    1.3

    P=0.124

    Liver Disease

    2.1

    P=0.006

    Smoker

    1.0

    P=0.947

    Figure- Flow Chart of Patient Inclusion

    David Dobrzynski Jr., MD1, Danielle Ndi, MPH2, Tiffanie Markus, PhD3, Yuwei Zhu, MS4, William Schaffner, MD, FIDSA, FSHEA3 and H. Keipp Talbot, MD, MPH5, (1)Vanderbilt University Medical Center, Nashville, TN, (2)Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, (3)Vanderbilt University School of Medicine, Nashville, TN, (4)Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, (5)Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN

    Disclosures:

    D. Dobrzynski Jr., None

    D. Ndi, None

    T. Markus, None

    Y. Zhu, None

    W. Schaffner, Merck: Member, Data Safety Monitoring Board , Consulting fee . Pfizer: Member, Data Safety Monitoring Board , Consulting fee . Dynavax: Consultant , Consulting fee . Seqirus: Consultant , Consulting fee . SutroVax: Consultant , Consulting fee . Shionogi: Consultant , Consulting fee .

    H. K. Talbot, Sanofi Pasteur: Investigator , Research grant . Gilead: Investigator , Research grant . MedImmune: Investigator , Research grant . Vaxinnate: Safety Board , none . Seqirus: Safety Board , none .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.