Assessment of risk factors for readmission in COPD patients at tertiary care centre RMCH Bareilly
Keywords:
chronic obstructive pulmonary disease, long term oxygen therapy, readmission, pulmonary rehabilitationAbstract
COPD is currently one of the top 3 causes of death in the world with high morbidity and mortality. Various studies showed if symptoms of COPD patients are not well controlled then chances of admission & readmission has been increased. To find reasons for readmission in such patients this study was conducted. Between January 2020 and December 2021, we prospectively evaluated all the patients who were readmitted for acute exacerbation of COPD at tertiary care hospital RMCH Bareilly. Total 119 patients were enrolled in our study. Among 119 patients 25(21.0%) patients were readmitted for acute exacerbation of COPD. Patients discharged on LTOT among them 16(64.0%) were readmitted. Sputum culture among readmitted patients showed pseudomonal growth in 10(40.0%) as important risk factor. Common Comorbidities observed as diabetes mellitus 8(32.0%), hypertension 6(24%) of readmitted patients. Duration of hospital stay on previous visit of more than 6 days was observed in 12(48.0%) of readmitted patients. Average duration of hospital stays was 7+/-3 days. We found that there are multiple factors contribute to the risk of readmission in COPD patients. Risks can be minimised by ensuring regular follow up and proper adherence to the treatment, proper nutrition and pulmonary rehabilitation.
Downloads
References
Enomoto LM, Shrestha DP, Rosenthal MB, Hollenbeak CS, Gabbay RA. Risk factors associated with 30-day readmission and length of stay in patients with type 2 diabetes. Journal of Diabetes and its Complications. 2017 Jan 1;31(1):122-7.
Barba R, Casasola GG, Marco J, Emilio Losa J, Plaza S, Canora J, Zapatero A. Anemia in chronic obstructive pulmonary disease: a readmission prognosis factor. Current medical research and opinion. 2012 Apr 1;28(4):617-22.
Bottle A, Honeyford K, Chowdhury F, Bell D, Aylin P. Factors associated with hospital emergency readmission and mortality rates in patients with heart failure or chronic obstructive pulmonary disease: a national observational study.
Burgel PR, Nesme-Meyer P, Chanez P, Caillaud D, Carré P, Perez T, Roche N. Cough and sputum production are associated with frequent exacerbations and hospitalizations in COPD subjects. Chest. 2009 Apr 1;135(4):975-82.
Candrilli SD, Dhamane AD, Meyers JL, Kaila S. Factors associated with inpatient readmission among managed care enrollees with COPD. Hospital Practice. 2015 Oct 2;43(4):199-207
Chaouat A, Weitzenblum E, Kessler R, Charpentier C, Enrhart M, Schott R, Levi-Valensi P, Zielinski J, Delaunois L, Cornudella R, dos Santos JM. A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients. European Respiratory Journal. 1999 Nov 1;14(5):1002-8
Chawla H, Bulathsinghala C, Tejada JP, Wakefield D, ZuWallack R. Physical activity as a predictor of thirty-day hospital readmission after a discharge for a clinical exacerbation of chronic obstructive pulmonary disease. Annals of the American Thoracic Society. 2014 Oct;11(8):1203-9.
Choi J, Oh JY, Lee YS, Hur GY, Lee SY, Shim JJ, Kang KH, Min KH. Pseudomonas aeruginosa infection increases the readmission rate of COPD patients. International Journal of Chronic Obstructive Pulmonary Disease. 2018;13:3077.
Coventry PA, Gemmell I, Todd CJ. Psychosocial risk factors for hospital readmission in COPD patients on early discharge services: a cohort study. BMC Pulm Med. 2011;11:49. doi: 10.1186/1471-2466-11-49. PubMed PMID: 22054636
Fuhrman C, Moutengou E, Roche N, Delmas MC. Prognostic factors after hospitalization for COPD exacerbation. Revue des Maladies Respiratoires. 2017 Jan 1;34(1):1-8.
Garcia-Aymerich J, Farrero E, Felez MA, Izquierdo J, Marrades RM, Anto JM. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003 Feb 1;58(2):100-5.
Garcia-Aymerich J, Monso E, Marrades RM, ESCARRABILL J, Felez MA, Sunyer J, Anto JM, EFRAM investigators. Risk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation: EFRAM study. American journal of respiratory and critical care medicine. 2001 Sep 15;164(6):1002-7.
Global strategy for prevention, diagnosis and management of copd: 2022 Report
Godtfredsen NS, Vestbo J, Osler M, Prescott E. Risk of hospital admission for COPD following smoking cessation and reduction: a Danish population study. Thorax. 2002 Nov 1;57(11):967-72.
Guerrero M, Crisafulli E, Liapikou A, Huerta A, Gabarrús A, Chetta A, Soler N, Torres A. Readmission for acute exacerbation within 30 days of discharge is associated with a subsequent progressive increase in mortality risk in COPD patients: a long-term observational study. PloS one. 2016 Mar 4;11(3):e0150737.
Guerrero M, Crisafulli E, Liapikou A, Huerta A, Gabarrús A, Chetta A, Soler N, Torres A. Readmission for acute exacerbation within 30 days of discharge is associated with a subsequent progressive increase in mortality risk in COPD patients: a long-term observational study. PloS one. 2016 Mar 4;11(3):e0150737.
Jacobs DM, Noyes K, Zhao J, Gibson W, Murphy TF, Sethi S, Ochs-Balcom HM. Early hospital readmissions after an acute exacerbation of chronic obstructive pulmonary disease in the nationwide readmissions database. Annals of the American Thoracic Society. 2018 Jul;15(7):837-45.
Kim TW, Choi ES, Kim WJ, Jo HS. The Association with COPD Readmission Rate and Access to Medical Institutions in Elderly Patients. International Journal of Chronic Obstructive Pulmonary Disease. 2021;16:1599
Lee YS, Choi J, Chung S, Choi JH, Sim JK, Oh JY, Min KH, Hur GY, Lee SY, Kang KH, Shim JJ. Pseudomonas infection and home oxygen therapy can increase readmission in patients with acute exacerbation of chronic obstructive pulmonary disease
McGhan R, Radcliff T, Fish R, Sutherland ER, Welsh C, Make B. Predictors of rehospitalisation and death after a severe exacerbation of COPD. Chest. 2007 Dec 1;132(6):1748-55.
Rinne ST, Graves MC, Bastian LA, Lindenauer PK, Wong ES, Hebert PL, Liu CF. Association between length of stay and readmission for COPD. The American journal of managed care. 2017 Aug 1;23(8):e253.
Rodrigo-Troyano A, Melo V, Marcos PJ, Laserna E, Peiro M, Suarez-Cuartin G, Perea L, Feliu A, Plaza V, Faverio P, Restrepo MI. Pseudomonas aeruginosa in chronic obstructive pulmonary disease patients with frequent hospitalized exacerbations: a prospective multicentre study. Respiration. 2018;96(5):417-24.
Rycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: a literature review. International journal of chronic obstructive pulmonary disease. 2012;7:457.
Simmering JE, Polgreen LA, Comellas AP, Cavanaugh JE, Polgreen PM. Identifying patients with COPD at high risk of readmission. Chronic Obstructive Pulmonary Diseases. 2016;3(4):729.
Yang F, Xiong ZF, Yang C, Li L, Qiao G, Wang Y, Zheng T, He H, Hu H. Continuity of care to prevent readmissions for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2017 Mar 30;14(2):251-61.
Zhong X, Lee S, Zhao C, Lee HK, Bain PA, Kundinger T, et al. Reducing COPD readmissions through predictive modeling and incentive-based interventions. Health Care Manag Sci. 2017. Epub 2017/11/28. doi: 10.1007/s10729-017-9426-2. PubMed PMID: 29177758.
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.