KUMJ | VOL. 18 | NO. 4 | ISSUE 72 | OCT.-DEC. 2020
Risk Factors Associated with Ninety Day Readmission in Chronic Obstructive Pulmonary Disease Exacerbation at a Tertiary Care Hospital: A retrospective cohort study
Pant P, Joshi A
Abstract: Background
Chronic obstructive pulmonary disease (COPD) exacerbation is a leading cause of
frequent hospital admission. Globally, several studies have reported potential risk
factors associated with COPD exacerbations which are largely unknown in Nepalese
health care setting.
Objective
To identify the risk factors associated with hospital readmission within ninety days of
discharge in acute COPD exacerbation.
Method
This is a hospital based retrospective cohort study conducted at Tribhuvan University
Teaching Hospital. COPD patients admitted in respiratory ward from August 2019
to November 2019 were followed up till 90 days after discharge. Logistic regression
analysis was performed at 95% Confidence Interval (CI) to identify risk factors for
readmission in COPD exacerbation. Statistical analysis was performed using SPSS
version 20.0.
Result
Of total 86 patients hospitalized for COPD, 42 (48.8%) had at least one subsequent
readmission during post-discharge follow-up period of 90 days. Mean age of patients
was 70.55±10.98 years. There were 45 (52.3%) males. Logistic regression analysis
revealed preadmission domiciliary oxygen use (Odds Ratio (OR) 2.93; 95% CI 1.1957.202;
p=0.019), admission in intensive care unit (ICU) (OR 3.060; 95% CI 1.1458.179;
p=0.026),
previous
hospital
admission
for
COPD
exacerbation
(OR
3.230;
95%
CI
1.219-8.556;
p=0.018),
age
(OR
0.946;
95%
CI
0.905-0.988;
p=0.012)
and
duration
of
hospital stay (OR 0.901; 95% CI 0.819-0.992; p=0.034) were independently
associated with ninety day readmission in COPD patients.
Conclusion
Five clinical factors were found to be independently associated with COPD
readmission in this study. Large multi-centre study at various health care levels is
recommended to validate the potential risk factors in different populations and
health care settings in Nepal.
Keyword : COPD, Readmission, Risk factors
