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Risk factors and associated outcomes of hospital readmission in COPD: A systematic review

Njoku, CM, Alqahtani, JS, Wimmer, BC ORCID: 0000-0003-3166-7126, Peterson, GM ORCID: 0000-0002-6764-3882, Kinsman, L, Hurst, JR and Bereznicki, BJ ORCID: 0000-0001-8463-4817 2020 , 'Risk factors and associated outcomes of hospital readmission in COPD: A systematic review' , Respiratory Medicine , doi: 10.1016/j.rmed.2020.105988.

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Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of unplanned readmission. There isneed to identify risk factors for, and strategies to prevent readmission in patients with COPD.Aim: To systematically review and summarise the prevalence, risk factors and outcomes associated with rehospitalisation due to COPD exacerbation.Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Fivedatabases were searched for relevant studies.Results: Fifty-seven studies from 30 countries met the inclusion criteria. The prevalence of COPD-related readmission varied from 2.6 to 82.2% at 30 days, 11.8–44.8% at 31–90 days, 17.9–63.0% at 6 months, and25.0–87.0% at 12 months post-discharge. There were differences in the reported factors associated with readmissions, which may reflect variations in the local context, such as the availability of community-based servicesto care for exacerbations of COPD. Hospitalisation in the previous year prior to index admission was the keypredictor of COPD-related readmission. Comorbidities (in particular asthma), living in a deprived area and livingin or discharge to a nursing home were also associated with readmission. Relative to those without readmissions,readmitted patients had higher in-hospital mortality rates, shorter long-term survival, poorer quality of life,longer hospital stay, increased recurrence of subsequent readmissions, and accounted for greater healthcarecosts.Conclusions: in the previous year was the principal risk factor for COPD-related readmissions.Variation in the prevalence and the reported factors associated with COPD-related readmission indicate that riskfactors cannot be generalised, and interventions should be tailored to the local healthcare environment.

Item Type: Article
Authors/Creators:Njoku, CM and Alqahtani, JS and Wimmer, BC and Peterson, GM and Kinsman, L and Hurst, JR and Bereznicki, BJ
Keywords: COPD, readmission, risk factors, consequences
Journal or Publication Title: Respiratory Medicine
Publisher: W B Saunders Co Ltd
ISSN: 0954-6111
DOI / ID Number: 10.1016/j.rmed.2020.105988
Copyright Information:

© 2020 Elsevier

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