Rates and Predictors of Hospital Readmission for COPD Exacerbation

A hospital patient
A hospital patient
One in 20 patients admitted to the hospital for an exacerbation of COPD was readmitted within 30 days.

NEW ORLEANS — One in 20 patients admitted to the hospital for an exacerbation of chronic obstructive pulmonary disease (COPD) was readmitted within 30 days, according to research results presented at the 2019 CHEST Annual Meeting, held October 19 to 23, 2019, in New Orleans, Louisiana.

Researchers conducted a retrospective cohort study using the 2016 National Readmission Database to determine the 30-day readmission rate following hospitalization for COPD exacerbations. The primary study outcome was 30-day all-cause and 30-day COPD-specific readmission; the secondary outcomes were independent predictors of readmission.

In total, 530,229 patients (mean age, 68 years; 58% women) were included in the study. All-cause and COPD-specific readmission rates were 16.3% and 5.4%, respectively. Independent predictors of readmission included leaving against medical advice (adjusted hazard ratio [aHR], 1.86), being treated at a high-volume center (aHR, 1.26), having a high Charlson score (aHR, 1.11), having low household income (aHR, 1.10), being treated at an urban teaching center (aHR, 1.10), being a man (aHR, 1.09), having Medicaid insurance (aHR, 1.07), being younger (aHR, 1.01), being admitted to a hospital with a large bed size (aHR, 1.03), and having a prolonged length of stay (aHR, 1.01).

The investigators noted that >1 in 10 patients were readmitted following hospitalization, with 1 in 20 being readmitted for a repeat COPD exacerbation within 30 days.

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“We identif[ied] multiple independent predictors of readmissions that can be used to identify high-risk patients who would benefit the most from interventions aimed at reducing readmission,” the researchers concluded.

Reference

Krishnan AM, Ramanathan R, Sama S, Madgula AS, Datta D. Predictors of 30-day readmission among patients with acute exacerbation of COPD. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 1740.