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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, CMA 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:	https://doi.org/10.1016/j.rmed.2020.105988
Copyright Information:	© 2020 Elsevier Ltd.
Related URLs:	UTAS Profile: Wimmer, BC UTAS Profile: Peterson, GM Google Scholar: Bereznicki, BJ UTAS Profile: Bereznicki, BJ
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