P-1875. A Quality Initiative to Understand Risk Factors for Pneumonia Readmissions at a Regional Medical Center

Abstract Background Pneumonia is a significant cause of hospitalizations in the United States, with 1 million pneumonia-related hospital admissions in 2014. Additionally, patients discharged after pneumonia treatment have a high all-cause 30-day readmission rate between 17%-25%. In order to create a quality improvement initiative to decrease pneumonia readmissions, we sought to identify risk factors, rates, and causes of readmission in patients with index admissions due to pneumonia. Most Common Readmission Comorbidities Methods We performed a manual review of deidentified electronic medical record (EMR) data to select adult patients hospitalized for pneumonia for four consecutive months over two years (August to November 2022 and 2023) at a regional medical center. We assessed the primary cause of readmission for patients readmitted within 30 days of discharge to understand the risk factors, associated comorbidities, and care received. Results EMR review identified 161 hospitalizations due to pneumonia in 8 months. Of these, 24 patients (15%) were readmitted within 30 days of hospital discharge, and most (15) of these readmissions were within 15 days. Notably, only 2 readmissions (8.3%) were due to pneumonia-related causes. The two most common causes for readmission were infections other than pneumonia (25%) and renal failure (21%). Most readmissions (14 readmissions [58%]) were classified as at risk for aspiration, and 4 (17%) were associated with opioid use. The most frequently seen comorbidities in readmission were aspiration risk/dysphagia, chronic kidney disease, chronic obstructive pulmonary disease, and atrial fibrillation (Figure 1). 15 out of 24 patients (63%) did not have a 30-day follow-up with their primary care provider. Conclusion Our data suggest that most readmissions were not directly related to pneumonia, further suggesting that patient comorbidities and risk factors play a more significant role. Quality improvement programs should focus on a broad, multidisciplinary approach to identify the most vulnerable patient populations and associated risk factors and prioritize prompt outpatient follow-up with a primary care physician. Disclosures All Authors: No reported disclosures