Health care-associated infections linked to increase in hospital readmissions

Issue: June 2012

Data from an 8-year analysis suggest there is an increased risk for hospital readmission among patients who acquire health care-associated infections.

For the retrospective cohort study, researchers from the University of Maryland School of Medicine set out to determine the association between three prevalent hospital-associated organisms and time to hospital readmission. The cohort included adult patients admitted to the University of Maryland Medical Center from 2001 to 2008.

Of the 136,513 patient admissions included in the study, 7,898 of patients had a culture positive for Clostridium difficile, methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci. A positive culture was obtained from 4,737 patients more than 48 hours after they were admitted to the hospital: 2,318 tested positive for MRSA, 1,174 for vancomycin-resistant enterococci and 1,643 for C. difficile.

Within 1 year after discharge, 35% of patients were readmitted. Patients who had a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR=1.4; 95% CI, 1.33-1.46). This was after adjustment for age, sex, admission length of stay, ICU stay, Charlson comorbidity index and year of hospital admission.

“Efforts to reduce health care-associated infections may have the additional benefit of reducing the incidence of hospital readmission and associated poor patient outcomes and increased health care costs,” the researchers wrote. “Furthermore, patients with a positive clinical culture result obtained more than 48 hours after hospital admission could be targeted to receive additional discharge planning resources designed to reduce the likelihood of hospital readmission.”

References:

Emerson CB. Infect Control Hosp Epidemiol. 2012;33:539-544.

Disclosures:

The researchers report no relevant financial disclosures.