The risk factors of early readmissions in COPD Exacerbations

Abstract

Background and Objective: It is known that hospital readmissions and frequent hospitalizations in hospitalized patients in Chronic Obstructive Pulmonary Disease (COPD) exacerbations shorten the survival. In this study, it was aimed to investigate the risk factors associated with “early readmission” in patients hospitalized for exacerbation of COPD within the first month after discharge from the hospital due to COPD exacerbation. Materials and Methods: In this study, 54 patients hospitalized due to COPD exacerbation in Chest Diseases Department of Cukurova University Faculty of Medicine Balcali Hospital between September 2015 and February 2016 enrolled and the risk factors for readmission within the first month after discharge is evaluated. Results: It was determined that 13 of 54 patients (24.1%) who participated in the study were readmissioned within the first month after discharge. The mean age of the patients in our study was 64.24 ± 9.95 and 84.6% of them were men. Although the mean age seemed to be more advanced in the early readmission group, this difference was not statistically significant (p> 0.05). The Charlson comorbidity index, lung cancer, moderate-severe kidney disease, presence of metastatic solid tumor, White Blood Cells (WBC) levels and low socioeconomic level were found to be significantly higher in the early readmission group (P = 0.029, P = 0.012, P = 0.015, P = 0.024, P, = 0.019 and P = 0.057 respectively). In addition, it was found that postbronchodilator Forced Expiratory Volume in first second / Forced Vital Capacity (FEV1 / FVC) was significantly lower in the group with early readmission. With multivariate regression analysis; the risk factors for readmission in the first 30 days after discharge were found as body mass index (BMI) and Charlson comorbidity index score, the other parameters could not reach the statistical significance. Conclusion: In this study, we determined the risk factors that increase the risk of early re-hospitalization were comorbidities, serum WBC count and socioeconomic factors.