The 30-day readmission rate after acute exacerbation of COPD was 26.4%, with risk factors including male sex, longer hospital stay, systemic steroid use, and high comorbidity index.
Cohort (n=16,105)
Yes
What are the prevalence and risk factors for readmission within 30 days of discharge after acute exacerbation of COPD?
Approximately one-quarter of patients hospitalized for acute COPD exacerbation are readmitted within 30 days, highlighting the need for targeted discharge planning for high-risk individuals.
Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.
Jo et al. (2020) conducted a cohort in Acute exacerbation of chronic obstructive pulmonary disease (COPD) (n=16,105). Patient and clinical risk factors (e.g., male sex, longer hospital stay, high comorbidity index) was evaluated on Readmission within 30 days of discharge. The 30-day readmission rate after acute exacerbation of COPD was 26.4%, with risk factors including male sex, longer hospital stay, systemic steroid use, and high comorbidity index.
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