Hospital Re-Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Respir Med. 2001 Nov;95(11):876-84. doi: 10.1053/rmed.2001.1180.

Abstract

A retrospective study was carried out in a Hong Kong regional hospital with 24-h emergency service, to study the factors associated with shorter time to re-admission after acute exacerbation of chronic obstructive pulmonary disease (COPD). From 1 January 1997 to 31 December 1997, the first admission (index admission) of each patient through the emergency room with COPD/chronic bronchitis/emphysema was included. A total of 551 patients fulfilled the inclusion criteria. The total acute and rehabilitative length of stay (mean +/- SD) was 9.41+/-11.67 days. Within 1 year after discharge, 327 patients (59 35%) were re-admitted at least once. Median time to first re-admission after discharge was 240 days. By Cox regression analysis, the following factors were independently associated with shorter time to re-admission: hospital admission within 1 year before index admission, total length of stay in index admission > 5 days, nursing home residency, dependency in self-care activities, right heart strain pattern on electrocardiogram, on high dose inhaled corticosteroid and actual bicarbonate level > 25 mmol l(-1). These factors may be relevant in the future planning of healthcare utilization for COPD patients.

MeSH terms

  • Activities of Daily Living
  • Acute Disease
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Confidence Intervals
  • Electrocardiography
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / etiology
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Time Factors

Substances

  • Glucocorticoids