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Frequent hospital readmissions for acute exacerbation of COPD and their associated factors.
Respirology 2006; 11(2):188-95R

Abstract

OBJECTIVE

The factors that determine frequent hospital readmissions for acute exacerbations of COPD (AECOPD) are poorly understood. The aim of this study was to ascertain rates of re-hospitalizations for AECOPD patients and evaluate factors associated with frequent readmissions for acute exacerbations.

METHODS

We conducted a cross-sectional survey of 186 patients with moderate to severe COPD with one or more admissions for acute exacerbations to two large general hospitals. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including depression and spirometry were ascertained in the stable state both before discharge and at 1-month post discharge.

RESULTS

Among them, 67% had one or more previous readmission, 46% had two or more, 9% had 10-20 readmissions in the 1-year period prior to current admission. There was a high prevalence of current or ex-heavy smokers, underweight patients, depression and consumption of psychotropic drugs, and low prevalence of caregiver support, pulmonary rehabilitation and influenza and pneumococcal vaccination. Univariate analysis showed that male sex, duration >5 years, FEV(1) < 50% predicted, use of psychotropic drugs, receipt of pulmonary rehabilitation and vaccination were significantly associated with frequent past readmissions. Multivariate analysis revealed that disease duration >5 years (odds ratio (OR) = 2.32; 95% confidence interval (CI): 1.09-4.92), FEV(1) < 50% predicted (OR = 2.60; 95% CI: 1.18-5.74), use of psychotropic drugs (OR = 13.47; 95% CI: 1.48-122.92) and vaccination status (OR = 3.27; 95% CI: 1.12-9.57) were independently associated with frequent readmissions for AECOPD.

CONCLUSION

Frequent past readmission for AECOPD was associated with disease severity and psychosocial distress and increased use of vaccinations.

Authors+Show Affiliations

Gerontological Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16548905

Citation

Cao, Zhenying, et al. "Frequent Hospital Readmissions for Acute Exacerbation of COPD and Their Associated Factors." Respirology (Carlton, Vic.), vol. 11, no. 2, 2006, pp. 188-95.
Cao Z, Ong KC, Eng P, et al. Frequent hospital readmissions for acute exacerbation of COPD and their associated factors. Respirology. 2006;11(2):188-95.
Cao, Z., Ong, K. C., Eng, P., Tan, W. C., & Ng, T. P. (2006). Frequent hospital readmissions for acute exacerbation of COPD and their associated factors. Respirology (Carlton, Vic.), 11(2), pp. 188-95.
Cao Z, et al. Frequent Hospital Readmissions for Acute Exacerbation of COPD and Their Associated Factors. Respirology. 2006;11(2):188-95. PubMed PMID: 16548905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequent hospital readmissions for acute exacerbation of COPD and their associated factors. AU - Cao,Zhenying, AU - Ong,Kian Chung, AU - Eng,Philip, AU - Tan,Wan Cheng, AU - Ng,Tze Pin, PY - 2006/3/22/pubmed PY - 2006/7/28/medline PY - 2006/3/22/entrez SP - 188 EP - 95 JF - Respirology (Carlton, Vic.) JO - Respirology VL - 11 IS - 2 N2 - OBJECTIVE: The factors that determine frequent hospital readmissions for acute exacerbations of COPD (AECOPD) are poorly understood. The aim of this study was to ascertain rates of re-hospitalizations for AECOPD patients and evaluate factors associated with frequent readmissions for acute exacerbations. METHODS: We conducted a cross-sectional survey of 186 patients with moderate to severe COPD with one or more admissions for acute exacerbations to two large general hospitals. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including depression and spirometry were ascertained in the stable state both before discharge and at 1-month post discharge. RESULTS: Among them, 67% had one or more previous readmission, 46% had two or more, 9% had 10-20 readmissions in the 1-year period prior to current admission. There was a high prevalence of current or ex-heavy smokers, underweight patients, depression and consumption of psychotropic drugs, and low prevalence of caregiver support, pulmonary rehabilitation and influenza and pneumococcal vaccination. Univariate analysis showed that male sex, duration >5 years, FEV(1) < 50% predicted, use of psychotropic drugs, receipt of pulmonary rehabilitation and vaccination were significantly associated with frequent past readmissions. Multivariate analysis revealed that disease duration >5 years (odds ratio (OR) = 2.32; 95% confidence interval (CI): 1.09-4.92), FEV(1) < 50% predicted (OR = 2.60; 95% CI: 1.18-5.74), use of psychotropic drugs (OR = 13.47; 95% CI: 1.48-122.92) and vaccination status (OR = 3.27; 95% CI: 1.12-9.57) were independently associated with frequent readmissions for AECOPD. CONCLUSION: Frequent past readmission for AECOPD was associated with disease severity and psychosocial distress and increased use of vaccinations. SN - 1323-7799 UR - https://www.unboundmedicine.com/medline/citation/16548905/Frequent_hospital_readmissions_for_acute_exacerbation_of_COPD_and_their_associated_factors_ L2 - https://doi.org/10.1111/j.1440-1843.2006.00819.x DB - PRIME DP - Unbound Medicine ER -