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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.
  • Xu T; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
  • Sun W; Department of Respiratory and Critical Care Medicine, Xishan People's Hospital of Wuxi City, Wuxi, People's Republic of China.
  • Zhao H; Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Wuxi, People's Republic of China.
  • Wang X; Department of Respiratory and Critical Care Medicine, Shuyang Hospital of Traditional Chinese Medicine, Suqian, People's Republic of China.
  • Yuan Q; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
  • Zhang X; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
  • Mao S; Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing, People's Republic of China.
  • Zhang X; Department of Respiratory and Critical Care Medicine, Nanjing Jiangning Hospital, Nanjing, People's Republic of China.
  • Zhao M; Department of Respiratory and Critical Care Medicine, Nanjing Gaochun People's Hospital, Nanjing, People's Republic of China.
  • Sheng Z; Department of Respiratory and Critical Care Medicine, Changshu First People's Hospital, Suzhou, People's Republic of China.
  • Zhang M; Department of Immunology, Nanjing Medical University, Nanjing, People's Republic of China.
  • Huang M; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
  • Ji N; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Int J Chron Obstruct Pulmon Dis ; 17: 2329-2341, 2022.
Article in English | MEDLINE | ID: covidwho-2237160
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Disease, Chronic Obstructive Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Int J Chron Obstruct Pulmon Dis Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Disease, Chronic Obstructive Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Int J Chron Obstruct Pulmon Dis Year: 2022 Document Type: Article