Readmission Due to Exacerbation of COPD: Associated Factors

Abstract

Objectives: To compare characteristics of patients readmitted after discharge by chronic obstructive pulmonary disease (COPD) exacerbation with those who were not readmitted and to identify factors associated with readmission risk.

Patients and methods: We randomly selected a group of 40 COPD patients with high frequency of readmissions (HFR), who had ≥ 2 admissions by COPD exacerbation within 30 days after the last admission in 2015, and another group of 40 COPD patients with low frequency of readmissions (LFR), with 0-1 admissions in that period.

Results: Patients of the HFR group, compared to those in LFR group, were more frequently males (p = 0.009), older (p = 0.022), had a higher degree of dyspnea (p = 0.044), worse lung function (p = 0.049), belonged more frequently to exacerbator emphysema phenotype (p < 0.001), and had a higher frequency of diabetes (p = 0.049). The variables independently associated with increased risk of HFR were sex (OR 0.06, 95% CI 0.01-0.63, in women in relation to males), exacerbator emphysema phenotype (OR 28.61, 95% CI 3.59 compared to non-exacerbator phenotype), complications during hospitalization (OR 0.09, 95% CI 0.01-0.62, compared with those without complications), destabilized heart failure (OR 5.25, 95% CI 1.11-24.75, compared to those who did not), and length of hospital stay (OR 0.79, 95% CI 0.65-0.95, per day).

Conclusions: Chronic obstructive pulmonary disease patients with HFR are more frequently male, older, have worse dyspnea, lower lung function, belong more frequent to exacerbator emphysema phenotype, and more frequently diabetics. The variables that continued to be independent predictors of HFR in the multivariate analysis were sex, phenotype, occurrence of complications during admission, destabilized heart failure, and length of hospital stay.

Keywords: Chronic obstructive; Hospitalization; Patient discharge; Patient readmission; Pulmonary disease.