Key result
Chronic cor pulmonale (OR 2.14; 95% CI 1.26-3.64), hypoproteinemia, and elevated PaCO2 were significantly associated with 31-day early readmission in patients with AECOPD.
Why the study?
What are the risk factors associated with early readmission (within 31 days) following an acute exacerbation of COPD?
Cohort (n=692)
No
What are the risk factors associated with early readmission (within 31 days) following an acute exacerbation of COPD?
Odds Ratio: 2.14 (95% CI 1.26–3.64)
p-value: p=0.005
Chronic cor pulmonale, hypoproteinemia, and elevated PaCO2 are significant risk factors for 31-day readmission in patients with acute exacerbation of COPD.
May inform risk stratification to reduce early AECOPD readmissions; hypothesis-generating and requires prospective validation.
BACKGROUND: The 31 day readmission rate is deemed to be an important indicator of the quality of medical care in China. The objectives of this study were to identify the readmission rate of acute exacerbation for chronic obstructive pulmonary disease (COPD) and to evaluate associated risk factors. METHODS: We retrospectively reviewed charts for patients with acute exacerbation of COPD (AECOPD) admitted to our hospital between January 2011 and November 2012. The early-readmission group and non-early-readmission group were determined by whether patients were readmitted within 31 days after discharge. Logistic regression analysis was performed to identify risk factors for early readmission following an AECOPD. RESULTS: There were 692 patients with 925 admissions during the 23 month period; 63 (6.8%) admissions met our criteria for early readmission. Multivariate analysis showed that chronic cor pulmonale (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.26-3.64, p = 0.005), hypoproteinemia (OR 2.02, 95% CI 1.03-3.95, p = 0.040) and an elevated PaCO2 (OR 1.03, 95% CI 1.00-1.06, p = 0.027) were identified as risk factors for early readmission of AECOPD. CONCLUSION: The readmission rate for AECOPD was 6.8%. AECOPD patients with chronic cor pulmonale, hypoproteinemia, and a high PaCO2 are at higher risk for readmission with 31 days of hospital discharge, and medical care of these patients warrants greater attention.
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Lin et al. (2013) conducted a cohort in Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n=692). Chronic cor pulmonale vs. Absence of chronic cor pulmonale was evaluated on Early readmission within 31 days after discharge (OR 2.14, 95% CI 1.26-3.64, p=0.005). Chronic cor pulmonale (OR 2.14; 95% CI 1.26-3.64), hypoproteinemia, and elevated PaCO2 were significantly associated with 31-day early readmission in patients with AECOPD.
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