scholarly journals Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Vol 14 ◽  
pp. 175346662096168
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong-Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

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.

Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Comorbid Condition ◽  
Obstructive Pulmonary Disease

Abstract Background 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 May 1, 2014, to May 1, 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. Conclusions Readmission occurred in approximately a 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 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 programs for COPD patients are necessary.

scholarly journals A Prediction Model for Intermediate- and High-risk Pulmonary Hypertension During the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Xilian Feng ◽  
Jiahua Liang ◽  
Jiamin Chen ◽  
Weiyan Chen ◽  
Hui Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Prediction Model ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Clinical Efficacy ◽  
Chronic Obstructive ◽  
Discriminative Ability ◽  
Obstructive Pulmonary Disease

Abstract Background: Pulmonary hypertension (PH) is a serious complication of COPD and is associated with poor prognosis. There are currently no established predictive models for PH during the acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Objective: To establish a prediction model for intermediate- and high-risk PH in AECOPD patients.Methods: This study collected data from 203 AECOPD patients and divided the patients into a model group and an external validation group. The influence of each parameter on PH was analysed through univariate and multivariate analyses, and these data were used to build a prediction model. Finally, the discriminative ability, calibration ability and clinical efficacy of the model were tested.Result: Age, RDW-CV and RDW-SD were related to PH, so these variables were used to establish a prediction model. In addition, the discriminative ability, calibration ability and clinical efficacy of the model were affirmed.Conclusion: This study established a clinical prediction model for AECOPD patients with PH, and the prediction model has certain clinical value for assisting in the screening of intermediate- and high-risk patients with PH.

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