[HTML][HTML] Risk factors and associated outcomes of hospital readmission in COPD: a systematic review
CM Njoku, JS Alqahtani, BC Wimmer, GM Peterson… - Respiratory …, 2020 - Elsevier
Respiratory Medicine, 2020•Elsevier
Background Chronic obstructive pulmonary disease (COPD) is a leading cause of
unplanned readmission. There is need 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. Five databases were searched for relevant studies …
unplanned readmission. There is need 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. Five databases were searched for relevant studies …
Background
Chronic obstructive pulmonary disease (COPD) is a leading cause of unplanned readmission. There is need 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. Five databases 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, and 25.0–87.0% 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 services to care for exacerbations of COPD. Hospitalisation in the previous year prior to index admission was the key predictor of COPD-related readmission. Comorbidities (in particular asthma), living in a deprived area and living in 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 healthcare costs.
Conclusions
Hospitalisation 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 risk factors cannot be generalised, and interventions should be tailored to the local healthcare environment.
Elsevier
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