[Risk factors of readmission in acute exacerbation of moderate-to-severe chronic obstructive pulmonary disease].

Abstract

OBJECTIVES:

More effective management of chronic obstructive pulmonary disease (COPD) and improved survival of COPD patients requires a better understanding of the risk factors for exacerbation. The aim of this study was to identify factors related to readmission in patients with moderate-to-severe COPD.

PATIENTS AND METHODS:

Ninety patients with moderate-to-severe COPD hospitalized consecutively for acute exacerbation were studied prospectively. At discharge, the following potential predictors were assessed: clinical and spirometric variables, arterial blood gases, and respiratory muscle strength determined noninvasively. The patients were followed for a period of 3 months. Readmission for exacerbation and time intervals free of hospitalization were recorded.

RESULTS:

Univariate analysis showed that the presence of cor pulmonale (P<.05), long-term oxygen therapy (P<.05), hypercapnia (P<.05), and high inspiratory load--mean inspiratory airway pressure measured at the mouth exceeding 0.40 cm H2O and a pressure-time index greater than 0.25 (P<.05 for both variables)--increased the risk of hospitalization for exacerbation. Multivariate analysis showed that only cor pulmonale (P<.05) and a high pressure-time index (>0.25, P<.05) were independently related to risk of readmission.

CONCLUSIONS:

Cor pulmonale and a high pressure-time index are independent risk factors for hospitalization for exacerbation of moderate-to-severe COPD.

• Authors: C González, E Servera, G Ferris, M L Blasco, J Marín
• Journal: Archivos de bronconeumologia (Arch Bronconeumol) Vol. 40 Issue 11 Pg. 502-7 (Nov 2004) ISSN: 0300-2896 [Print] Spain
• Vernacular Title: Factores predictivos de reingreso hospitalario en la agudización de la EPOC moderada-grave.
• PMID: 15530342 (Publication Type: English Abstract, Journal Article)

Chemical References

• Oxygen

Topics

• Acute Disease
• Aged
• Female
• Health Status
• Hospitalization
• Humans
• Male
• Oxygen (therapeutic use)
• Patient Readmission (statistics & numerical data)
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (epidemiology, rehabilitation, therapy)
• Risk Factors
• Severity of Illness Index