Jaber S Alqahtani1,2, Chidiamara M Njoku3, Bonnie Bereznicki3, Barbara C Wimmer3, Gregory M Peterson3, Leigh Kinsman4, Yousef S Aldabayan5,6, Ahmed M Alrajeh5,6, Abdulelah M Aldhahir5,7, Swapna Mandal5,8, John R Hurst5. 1. UCL Respiratory, University College London, London, UK Alqahtani-Jaber@hotmail.com. 2. Dept of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia. 3. School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia. 4. School of Nursing and Midwifery, University of Newcastle, Port Macquarie, Australia. 5. UCL Respiratory, University College London, London, UK. 6. Dept of Respiratory Care, King Faisal University, Al Ahsa, Saudi Arabia. 7. Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia. 8. Royal Free London NHS Foundation Trust, London, UK.
Abstract
BACKGROUND: Readmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD. METHODS: We systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis where this was possible using a random-effects model. RESULTS: In total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged from 8.8-26.0% at 30 days and from 17.5-39.0% at 90 days. Our narrative synthesis showed that comorbidities, previous exacerbations and hospitalisations, and increased length of initial hospital stay were the major risk factors for readmission at 30 and 90 days. Pooled adjusted odds ratios (95% confidence intervals) revealed that heart failure (1.29 (1.22-1.37)), renal failure (1.26 (1.19-1.33)), depression (1.19 (1.05-1.34)) and alcohol use (1.11 (1.07-1.16)) were all associated with an increased risk of 30-day all-cause readmission, whereas being female was a protective factor (0.91 (0.88-0.94)). CONCLUSIONS: Comorbidities, previous exacerbations and hospitalisation, and increased length of stay were significant risk factors for 30- and 90-day all-cause readmission after an index hospitalisation with an exacerbation of COPD.
BACKGROUND: Readmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD. METHODS: We systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis where this was possible using a random-effects model. RESULTS: In total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged from 8.8-26.0% at 30 days and from 17.5-39.0% at 90 days. Our narrative synthesis showed that comorbidities, previous exacerbations and hospitalisations, and increased length of initial hospital stay were the major risk factors for readmission at 30 and 90 days. Pooled adjusted odds ratios (95% confidence intervals) revealed that heart failure (1.29 (1.22-1.37)), renal failure (1.26 (1.19-1.33)), depression (1.19 (1.05-1.34)) and alcohol use (1.11 (1.07-1.16)) were all associated with an increased risk of 30-day all-cause readmission, whereas being female was a protective factor (0.91 (0.88-0.94)). CONCLUSIONS: Comorbidities, previous exacerbations and hospitalisation, and increased length of stay were significant risk factors for 30- and 90-day all-cause readmission after an index hospitalisation with an exacerbation of COPD.
Authors: Davies Adeloye; Omer Elneima; Luke Daines; Krisnah Poinasamy; Jennifer K Quint; Samantha Walker; Chris E Brightling; Salman Siddiqui; John R Hurst; James D Chalmers; Paul E Pfeffer; Petr Novotny; Thomas M Drake; Liam G Heaney; Igor Rudan; Aziz Sheikh; Anthony De Soyza Journal: Lancet Respir Med Date: 2021-08-17 Impact factor: 30.700
Authors: Jaber S Alqahtani; Renata G Mendes; Abdulelah Aldhahir; Daniel Rowley; Mohammed D AlAhmari; George Ntoumenopoulos; Saeed M Alghamdi; Jithin K Sreedharan; Yousef S Aldabayan; Tope Oyelade; Ahmed Alrajeh; Carlo Olivieri; Maher AlQuaimi; Jerome Sullivan; Mohammed A Almeshari; Antonio Esquinas Journal: J Multidiscip Healthc Date: 2020-11-18
Authors: Jaber S Alqahtani; Abdulelah M Aldhahir; Tope Oyelade; Saeed M Alghamdi; Ahmad S Almamary Journal: NPJ Prim Care Respir Med Date: 2021-05-06 Impact factor: 2.871
Authors: Simona Tabea Huebner; Simona Henny; Stéphanie Giezendanner; Thomas Brack; Martin Brutsche; Prashant Chhajed; Christian Clarenbach; Thomas Dieterle; Adrian Egli; Martin Frey; Ingmar Heijnen; Sarosh Irani; Noriane Andrina Sievi; Robert Thurnheer; Marten Trendelenburg; Malcolm Kohler; Anne Barbara Leuppi-Taegtmeyer; Joerg Daniel Leuppi Journal: Respiration Date: 2021-12-23 Impact factor: 3.966
Authors: María Gómez Antúnez; Antonio Muiño Míguez; Alejandro David Bendala Estrada; Guillermo Maestro de la Calle; Daniel Monge Monge; Ramón Boixeda; Javier Ena; Carmen Mella Pérez; Juan Miguel Anton Santos; Carlos Lumbreras Bermejo Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-01-05
Authors: Jaber S Alqahtani; Tope Oyelade; Jithin Sreedharan; Abdulelah M Aldhahir; Saeed M Alghamdi; Ahmed M Alrajeh; Abdullah S Alqahtani; Abdullah Alsulayyim; Yousef S Aldabayan; Nowaf Y Alobaidi; Mohammed D AlAhmari Journal: BMJ Open Respir Res Date: 2020-09