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Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease.
Respiration 2006; 73(3):311-7R

Abstract

BACKGROUND

Hospital readmissions for acute exacerbation of chronic obstructive pulmonary disease (COPD) are one of the leading causes of health care expenditures worldwide.

OBJECTIVES

To identify risk factors for hospital readmission in COPD patients.

METHODS

We prospectively evaluated 129 consecutive patients hospitalized for acute exacerbation of COPD. Clinical, spirometric and arterial blood gas variables were measured during hospitalization. Socioeconomic characteristics, comorbidity, dyspnea, functional dependence, depression, social support and quality of life were also analyzed. Readmission was defined as one or more hospitalizations in the following year.

RESULTS

During the follow-up period, 75 (58.5%) patients were readmitted. In bivariate analysis, readmission was associated with previous hospitalization for COPD in the past year, dyspnea scale, PaCO(2) at discharge, depression, cor pulmonale, chronic domiciliary oxygen and quality of life measured by the St. George's Respiratory Questionnaire. In multivariate analysis, the best predictor of readmission was the combination of hospitalization for COPD in the previous year (odds ratio, OR: 4.27; 95% confidence interval, CI: 1.5-12), the total score of the St. George's Respiratory Questionnaire >or=50 points (OR: 2.36; 95% CI: 1.03-5.04) and PaCO(2) at discharge >or=45 mm Hg (OR: 2.18; 95% CI: 0.84-5.06). With this model, the probability of readmission for patients without any of these variables was 7%, while it was 70% for the patients with all three variables present.

CONCLUSION

The combination of quality of life, hospitalization for COPD in the previous year and hypercapnia at discharge are useful predictors of readmission at 1 year.

Authors+Show Affiliations

Department of Internal Medicine, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain. 19908pam@comb.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16155352

Citation

Almagro, Pedro, et al. "Risk Factors for Hospital Readmission in Patients With Chronic Obstructive Pulmonary Disease." Respiration; International Review of Thoracic Diseases, vol. 73, no. 3, 2006, pp. 311-7.
Almagro P, Barreiro B, Ochoa de Echaguen A, et al. Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration. 2006;73(3):311-7.
Almagro, P., Barreiro, B., Ochoa de Echaguen, A., Quintana, S., Rodríguez Carballeira, M., Heredia, J. L., & Garau, J. (2006). Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration; International Review of Thoracic Diseases, 73(3), pp. 311-7.
Almagro P, et al. Risk Factors for Hospital Readmission in Patients With Chronic Obstructive Pulmonary Disease. Respiration. 2006;73(3):311-7. PubMed PMID: 16155352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. AU - Almagro,Pedro, AU - Barreiro,Bienvenido, AU - Ochoa de Echaguen,Anna, AU - Quintana,Salvador, AU - Rodríguez Carballeira,Mónica, AU - Heredia,José L, AU - Garau,Javier, Y1 - 2005/09/06/ PY - 2004/09/30/received PY - 2005/03/30/accepted PY - 2005/9/13/pubmed PY - 2006/10/18/medline PY - 2005/9/13/entrez SP - 311 EP - 7 JF - Respiration; international review of thoracic diseases JO - Respiration VL - 73 IS - 3 N2 - BACKGROUND: Hospital readmissions for acute exacerbation of chronic obstructive pulmonary disease (COPD) are one of the leading causes of health care expenditures worldwide. OBJECTIVES: To identify risk factors for hospital readmission in COPD patients. METHODS: We prospectively evaluated 129 consecutive patients hospitalized for acute exacerbation of COPD. Clinical, spirometric and arterial blood gas variables were measured during hospitalization. Socioeconomic characteristics, comorbidity, dyspnea, functional dependence, depression, social support and quality of life were also analyzed. Readmission was defined as one or more hospitalizations in the following year. RESULTS: During the follow-up period, 75 (58.5%) patients were readmitted. In bivariate analysis, readmission was associated with previous hospitalization for COPD in the past year, dyspnea scale, PaCO(2) at discharge, depression, cor pulmonale, chronic domiciliary oxygen and quality of life measured by the St. George's Respiratory Questionnaire. In multivariate analysis, the best predictor of readmission was the combination of hospitalization for COPD in the previous year (odds ratio, OR: 4.27; 95% confidence interval, CI: 1.5-12), the total score of the St. George's Respiratory Questionnaire >or=50 points (OR: 2.36; 95% CI: 1.03-5.04) and PaCO(2) at discharge >or=45 mm Hg (OR: 2.18; 95% CI: 0.84-5.06). With this model, the probability of readmission for patients without any of these variables was 7%, while it was 70% for the patients with all three variables present. CONCLUSION: The combination of quality of life, hospitalization for COPD in the previous year and hypercapnia at discharge are useful predictors of readmission at 1 year. SN - 0025-7931 UR - https://www.unboundmedicine.com/medline/citation/16155352/Risk_factors_for_hospital_readmission_in_patients_with_chronic_obstructive_pulmonary_disease_ L2 - https://www.karger.com?DOI=10.1159/000088092 DB - PRIME DP - Unbound Medicine ER -