Risk factors associated with chronic obstructive pulmonary disease early readmission

Abstract

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.

Keywords::

• COPD
• Exacerbation
• Readmission
• Risk factors

Transparency

Declaration of funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Declaration of financial/other relationships

J.L., Y.X., X.W., M.C., L.L., L.G., and J.F. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

We are grateful to David Larrabee MD, Brian Robinson MD and Liegan Chia MD for revision of this manuscript.