Chidiamara M Njoku1, Jaber S Alqahtani2, Barbara C Wimmer3, Gregory M Peterson3, Leigh Kinsman4, John R Hurst5, Bonnie J Bereznicki6. 1. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: chidi2njoku@yahoo.co.uk. 2. UCL Respiratory, University College London, London, UK; Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia. 3. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia. 4. School of Nursing and Midwifery, University of Newcastle, Port Macquarie, New South Wales, Australia. 5. UCL Respiratory, University College London, London, UK. 6. School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Abstract
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.
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.
Authors: Swapna Mandal; John R Hurst; Jaber S Alqahtani; Yousef S Aldabayan; Abdulelah M Aldhahir; Ahmad M Al Rajeh Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-10-07
Authors: Jaber S Alqahtani; Ahmad M Al Rajeh; Abdulelah M Aldhahir; Yousef S Aldabayan; John R Hurst; Swapna Mandal Journal: ERJ Open Res Date: 2021-12-20
Authors: Jaber S Alqahtani; Tope Oyelade; Abdulelah M Aldhahir; Renata Gonçalves Mendes; Saeed M Alghamdi; Marc Miravitlles; Swapna Mandal; John R Hurst Journal: PLoS One Date: 2021-08-03 Impact factor: 3.240