Cargando…
Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study
PURPOSE: Hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is considered as severe exacerbations. Readmission for severe exacerbations is a crucial event for COPD patients. However, factors associated with readmission for severe exacerbations are incomplete. T...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509010/ https://www.ncbi.nlm.nih.gov/pubmed/36164549 http://dx.doi.org/10.2147/COPD.S376909 |
_version_ | 1784797141673181184 |
---|---|
author | Xu, Tingting Sun, Wei Zhao, Hongqing Wang, Xinmin Yuan, Qi Zhang, Xijie Mao, Shan Zhang, Xiuwei Zhao, Mingming Sheng, Zebo Zhang, Mingshun Huang, Mao Ji, Ningfei |
author_facet | Xu, Tingting Sun, Wei Zhao, Hongqing Wang, Xinmin Yuan, Qi Zhang, Xijie Mao, Shan Zhang, Xiuwei Zhao, Mingming Sheng, Zebo Zhang, Mingshun Huang, Mao Ji, Ningfei |
author_sort | Xu, Tingting |
collection | PubMed |
description | PURPOSE: Hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is considered as severe exacerbations. Readmission for severe exacerbations is a crucial event for COPD patients. However, factors associated with readmission for severe exacerbations are incomplete. The study aimed to investigate different characteristics between the severe and non-severe exacerbation groups. PATIENTS AND METHODS: Patients hospitalized for severe AECOPD were included in multi-centers, and their exacerbations in next 12 months after discharge were recorded. According to exacerbations, patients were separated into the severe-exacerbation group and the non-severe exacerbation group. Propensity-score matching (PSM) and multivariable analyses were performed to compare the baseline characteristics of two groups. The Hosmer-Lemeshow test and receiver operating characteristic curve were applied to evaluate how well the model could identify clusters. RESULTS: The cohort included 550 patients with severe AECOPD across 27 study centers in China, and 465 patients were finally analyzed. A total of 41.5% of patients underwent readmission for AECOPD within 1 year. There were no significant differences in baseline characteristics between groups after PSM. Severe exacerbations in the 12 months were related to some factors, eg, the duration of COPD (13 vs 8 years, P<0.001), the COPD Assessment Test (CAT) score (20 vs 17, P<0.001), the blood eosinophil percentage (1.5 vs 2.0, P<0.05), and their inhaler therapies. Patients readmitted with AECOPD had a longer time of diagnosis (≥9 years), more symptoms (CAT ≥10), and lower blood eosinophils (Eos <2%). A clinical model was derived to help identify patients at risk of readmission with severe exacerbations. CONCLUSION: These analyses confirmed the relevance of COPD at admission with future severe exacerbations. A lower blood eosinophils percentage appears to be related to readmission when combined with clinical history. Further studies are needed to evaluate whether this study can predict the risk of exacerbations. |
format | Online Article Text |
id | pubmed-9509010 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-95090102022-09-25 Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study Xu, Tingting Sun, Wei Zhao, Hongqing Wang, Xinmin Yuan, Qi Zhang, Xijie Mao, Shan Zhang, Xiuwei Zhao, Mingming Sheng, Zebo Zhang, Mingshun Huang, Mao Ji, Ningfei Int J Chron Obstruct Pulmon Dis Original Research PURPOSE: Hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is considered as severe exacerbations. Readmission for severe exacerbations is a crucial event for COPD patients. However, factors associated with readmission for severe exacerbations are incomplete. The study aimed to investigate different characteristics between the severe and non-severe exacerbation groups. PATIENTS AND METHODS: Patients hospitalized for severe AECOPD were included in multi-centers, and their exacerbations in next 12 months after discharge were recorded. According to exacerbations, patients were separated into the severe-exacerbation group and the non-severe exacerbation group. Propensity-score matching (PSM) and multivariable analyses were performed to compare the baseline characteristics of two groups. The Hosmer-Lemeshow test and receiver operating characteristic curve were applied to evaluate how well the model could identify clusters. RESULTS: The cohort included 550 patients with severe AECOPD across 27 study centers in China, and 465 patients were finally analyzed. A total of 41.5% of patients underwent readmission for AECOPD within 1 year. There were no significant differences in baseline characteristics between groups after PSM. Severe exacerbations in the 12 months were related to some factors, eg, the duration of COPD (13 vs 8 years, P<0.001), the COPD Assessment Test (CAT) score (20 vs 17, P<0.001), the blood eosinophil percentage (1.5 vs 2.0, P<0.05), and their inhaler therapies. Patients readmitted with AECOPD had a longer time of diagnosis (≥9 years), more symptoms (CAT ≥10), and lower blood eosinophils (Eos <2%). A clinical model was derived to help identify patients at risk of readmission with severe exacerbations. CONCLUSION: These analyses confirmed the relevance of COPD at admission with future severe exacerbations. A lower blood eosinophils percentage appears to be related to readmission when combined with clinical history. Further studies are needed to evaluate whether this study can predict the risk of exacerbations. Dove 2022-09-20 /pmc/articles/PMC9509010/ /pubmed/36164549 http://dx.doi.org/10.2147/COPD.S376909 Text en © 2022 Xu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Xu, Tingting Sun, Wei Zhao, Hongqing Wang, Xinmin Yuan, Qi Zhang, Xijie Mao, Shan Zhang, Xiuwei Zhao, Mingming Sheng, Zebo Zhang, Mingshun Huang, Mao Ji, Ningfei Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title | Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title_full | Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title_fullStr | Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title_full_unstemmed | Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title_short | Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study |
title_sort | characteristics of 12-month readmission for hospitalized patients with copd: a propensity score matched analysis of prospective multicenter study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509010/ https://www.ncbi.nlm.nih.gov/pubmed/36164549 http://dx.doi.org/10.2147/COPD.S376909 |
work_keys_str_mv | AT xutingting characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT sunwei characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT zhaohongqing characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT wangxinmin characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT yuanqi characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT zhangxijie characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT maoshan characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT zhangxiuwei characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT zhaomingming characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT shengzebo characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT zhangmingshun characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT huangmao characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy AT jiningfei characteristicsof12monthreadmissionforhospitalizedpatientswithcopdapropensityscorematchedanalysisofprospectivemulticenterstudy |