Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd.

Bibliographic Details
Title: Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd.
Authors: Sara Fernández-García, Cristina Represas-Represas, Alberto Ruano-Raviña, Cecilia Mouronte-Roibás, Maribel Botana-Rial, Cristina Ramos-Hernández, Alberto Fernández-Villar
Source: PLoS ONE, Vol 15, Iss 2, p e0229257 (2020)
Publisher Information: Public Library of Science (PLoS), 2020.
Publication Year: 2020
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: INTRODUCTION AND OBJECTIVES:The aim of this study was to evaluate the predictive ability of multiple social, and clinical factors for readmission after a severe acute exacerbation of COPD (AECOPD) during various time periods. METHODS:We performed a prospective cohort study in which recruited patients with AECOPD. We systematically collected numerous clinical (symptoms, pulmonary function, comorbidities, and treatment) and social (financial situation, housing situation, family support, caregiver overload, ability to perform activities, and risk of social exclusion) variables using several questionnaires and indices. The patients were followed closely for one year and readmissions at 30, 60, and 365 days were analysed. RESULTS:253 patients were included, aged 68.9±9.8years, FEV1 = 42.1%±14.2%, and a Charlson's index = 1.8±0.9. Of these patients, 20.2%, 39.6%, and 63.7% were readmitted within the first 30, 90, and 365 days after discharge, respectively. In the multivariate model applied, the variables that were independently associated with readmission over all three periods of the analysis were dependence to perform basic activities of daily living (BADLs) (odds ratio [OR] = 2.10-4.10) and a history of two or more admissions within the previous year (OR = 2.78-3.78). At 90 days, a history of bacterial isolates in a previous sputum culture (OR = 2.39) and at 365 days, a high grade of dyspnoea (OR = 2.51) and obesity (OR = 2.38) were also identified as predictors of hospital readmission. CONCLUSIONS:The patients' limitation to perform BADLs and their history of admissions for AECOPD were the best predictive variables for the likelihood of readmission when adjusted for many other social and clinical variables, regardless of the time period considered for such prediction.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0229257
Access URL: https://doaj.org/article/31394050653845c8b5f2ebb050732fec
Accession Number: edsdoj.31394050653845c8b5f2ebb050732fec
Database: Directory of Open Access Journals
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More Details
ISSN:19326203
DOI:10.1371/journal.pone.0229257
Published in:PLoS ONE
Language:English