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Vol. 73, No. 3, 2006
Issue release date: May 2006
Section title: Clinical Investigations
Respiration 2006;73:311–317
(DOI:10.1159/000088092)

Risk Factors for Hospital Readmission in Patients with Chronic Obstructive Pulmonary Disease

Almagro P. · Barreiro B. · Ochoa de Echagüen A. · Quintana S. · Rodríguez Carballeira M. · Heredia J.L. · Garau J.
aDepartment of Internal Medicine, and bRespiratory and cIntensive Care Units, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain

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Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: 5/5/2006

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES

Abstract

Background: Hospital readmissions for acute exacerbation of chronic obstructive pulmonary disease (COPD) are one of the leading causes of healthcare expenditures worldwide. Objectives: To identify risk factors for hospital readmission in COPD patients. Methods:We prospectively evaluated 129 consecutive patients hospitalized for acute exacerbation of COPD. Clinical, spirometric and arterial blood gas variables were measured during hospitalization. Socioeconomic characteristics, comorbidity, dyspnea, functional dependence, depression, social support and quality of life were also analyzed. Readmission was defined as one or more hospitalizations in the following year. Results:During the follow-up period, 75 (58.5%) patients were readmitted. In bivariate analysis, readmission was associated with previous hospitalization for COPD in the past year, dyspnea scale, PaCO2 at discharge, depression, cor pulmonale, chronic domiciliary oxygen and quality of life measured by the St. George’s Respiratory Questionnaire. In multivariate analysis, the best predictor of readmission was the combination of hospitalization for COPD in the previous year (odds ratio, OR: 4.27; 95% confidence interval, CI: 1.5–12), the total score of the St. George’s Respiratory Questionnaire ≧50 points (OR: 2.36; 95% CI: 1.03–5.04) and PaCO2 at discharge ≧45 mm Hg (OR: 2.18; 95% CI: 0.84–5.06). With this model, the probability of readmission for patients without any of these variables was 7%, while it was 70% for the patients with all three variables present. Conclusion: The combination of quality of life, hospitalization for COPD in the previous year and hypercapnia at discharge are useful predictors of readmission at 1 year.


  

Author Contacts

Pedro Almagro, MD
Departamento de Medicina, Universitat Autònoma de Barcelona
Hospital Mútua de Terrassa, Plaza Dr. Robert 5
ES–08221 Terrassa (Spain)
Tel. +34 937365050, Fax +34 937365059, E-Mail 19908pam@comb.es

  

Article Information

Received: September 30, 2004
Accepted after revision: March 30, 2005
Published online: September 6, 2005
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 4, Number of References : 32

  

Publication Details

Respiration (International Journal of Thoracic Medicine)

Vol. 73, No. 3, Year 2006 (Cover Date: May 2006)

Journal Editor: Bolliger, C.T. (Cape Town)
ISSN: 0025–7931 (print), 1423–0356 (Online)

For additional information: http://www.karger.com/RES


Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Published online: 5/5/2006

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES


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