P19 How do risk assessment models impact 30 day unplanned hospital readmissions in adult patients receiving outpatient parenteral antimicrobial therapy (OPAT)? - A systematic review

Sep 29, 2026

Outpatient parenteral antimicrobial therapy (OPAT) can improve health-related quality of life, yet unplanned hospital readmissions may worsen satisfaction and reduce cost-effectiveness. This systematic review evaluated whether OPAT-specific risk assessment models influence 30-day unplanned readmissions among adult patients. Searches across major databases identified 435 articles, with three studies meeting inclusion criteria. Findings show mixed predictive performance, no clear benefit on unplanned readmissions, and infection-related causes dominate, with evidence limited by heterogeneity in several factors.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Methods

Results

Conclusions

Posters Abstract citation ID: dlaf239.023 P19 How do risk assessment models impact 30 day unplanned hospital readmissions in adult patients receiving outpatient parenteral antimicrobial therapy (OPAT)? A systematic review T. M. Finnegan1, A. Phelan2, B. J. O’Kelly3,4 1Community Intervention Team, Louth, Ireland; 2Trinity College, Dublin, Ireland; 3Our Lady of Lourdes Hospital, Drogheda, Ireland; 4Royal College of Surgeons in Ireland, Ireland Background: Outpatient parenteral antimicrobial therapy (OPAT) enhances health-related quality of life; however, unplanned readmissions may reduce patient satisfaction and the cost-effectiveness of the treatment. By predicting and minimizing these unplanned readmissions, patient outcomes can be signiﬁcantly improved. Predictive models for unplanned OPAT readmissions can help identify high-risk patients, enabling tailored care and support. However, data on the effectiveness of OPAT-speciﬁc models is limited. This systematic review assessed the impact of risk assessment models on 30 day unplanned hospital readmissions among adult OPAT patients. Methods: A systematic review aiming to measure the impact of readmission risk models on 30 day unplanned hospital readmissions in adult OPAT patients. Searching CINAHL, Medline, Embase, ASSIA and Web of Science identiﬁed 435 potential articles. Independent selection, data extraction, tabulation of ﬁndings, and analysis were completed. Meta-analysis was conducted using JBI Sumari. When a meta-analysis was not feasible due to inappropriate data formats, the results were reported narratively. Results: Three studies met the inclusion criteria. The primary outcome of the review was to measure the impact of OPAT readmission risk models on 30 day hospital readmissions by evaluating their ability to accurately predict readmissions within 30 days. Two studies reported low c-statistics, indicating poor discriminative capability, while one study showed a c-statistic of 0.75 in a temporal validation cohort, suggesting modest discriminative ability but lower accuracy in a broader group. A meta-analysis of the likelihood of unplanned readmissions in OPAT patients found no signiﬁcant differences in unplanned readmissions. Across the studies, the most common reason for readmission was infection-related, followed by adverse drug events and complications from vascular access devices. There were few reported readmissions for diarrhoea. The studies identiﬁed different risk factors for readmission depending on the patient case mix, the structure of the OPAT service, and the methods of OPAT delivery. Aminoglycosides and daptomycin were linked to a lower likelihood of readmissions, while other factors showed no clear trends. Results on endovascular infections and concurrent antimicrobial use had low heterogeneity indicating that the results can be trusted, but ﬁndings regarding drug-resistant organisms, age, Charlson Comorbidity Index, and previous admissions should be interpreted with caution due to high heterogeneity. Conclusions: The most common reason for readmissions was infection related. Thereview did not deﬁnitively identify risk factors for readmission and the impact of the OPAT readmission risk models was inconclusive. Further research is needed to enhance the transportability of these models and to develop versions tailored to different settings.

FAQs

What was the main focus of this systematic review?

To measure how readmission risk assessment models affect 30-day unplanned hospital readmissions in adult OPAT patients receiving outpatient parenteral antimicrobial therapy.

How were articles selected and analyzed?

The review searched CINAHL, Medline, Embase, ASSIA, and Web of Science, then performed independent selection and data extraction. Meta-analysis used JBI Sumari when data formats allowed; otherwise results were reported narratively.

What did the review find about model performance and readmission causes?

Predictive accuracy was low overall in two studies, with one showing a c-statistic of 0.75 in temporal validation. Unplanned readmissions showed no significant differences in likelihood, and infection-related reasons were the most common for readmission.

Sep 29, 2026

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