A Study on the Factors Contributing to Early Readmission After Acute Exacerbation in Copd Patients in a Tertiary Care Center in Kerala- Observational Prospective Study

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. This study aimed to determine the proportion of early readmissions and identify risk factors for early readmission in COPD patients hospitalized for AECOPD in a tertiary care center in Kerala, India. Methods: A prospective observational study was conducted among 140 COPD patients admitted with AECOPD. Socio-demographic, clinical, and treatment data were collected using a pre-designed proforma. Patients were followed up for 30 days post-discharge to assess re-admission status. Risk analysis and regression analysis were performed to identify risk factors. Results: The mean age of the participants was 68.9±7.6 years, with a male predominance (81.4%). The readmission rate within 30 days was 34.3%. Ahigher BODE index score (OR=1.873, 95% CI: 0.967-3.628, p=0.063) and 66% of patients had inadequate inhaler technique. The difference was found to be statistically significant and identified as a significant predictor of readmission. Prior hospitalization (OR=0.097, 95% CI: 0.033-0.286, p<0.001) was associated with increased readmission. Conclusion: One-third of COPD patients had early readmission within 30 days of initial hospitalization for AECOPD. Prior hospitalization, a higher BODE index score, and poor inhaler technique were significant risk factors for early readmission. Pulmonary rehabilitation, vaccination, AEC, CRP, smoking, long-term oxygen therapy, and NIV were not associated with early readmission in this study