Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd.
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 patient...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0229257 |
| _version_ | 1818578341413781504 |
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| author | Sara Fernández-García Cristina Represas-Represas Alberto Ruano-Raviña Cecilia Mouronte-Roibás Maribel Botana-Rial Cristina Ramos-Hernández Alberto Fernández-Villar |
| author_facet | Sara Fernández-García Cristina Represas-Represas Alberto Ruano-Raviña Cecilia Mouronte-Roibás Maribel Botana-Rial Cristina Ramos-Hernández Alberto Fernández-Villar |
| author_sort | Sara Fernández-García |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T06:44:16Z |
| format | Article |
| id | doaj.art-31394050653845c8b5f2ebb050732fec |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T06:44:16Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-31394050653845c8b5f2ebb050732fec2022-12-21T22:40:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01152e022925710.1371/journal.pone.0229257Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd.Sara Fernández-GarcíaCristina Represas-RepresasAlberto Ruano-RaviñaCecilia Mouronte-RoibásMaribel Botana-RialCristina Ramos-HernándezAlberto Fernández-VillarINTRODUCTION 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.https://doi.org/10.1371/journal.pone.0229257 |
| spellingShingle | Sara Fernández-García Cristina Represas-Represas Alberto Ruano-Raviña Cecilia Mouronte-Roibás Maribel Botana-Rial Cristina Ramos-Hernández Alberto Fernández-Villar Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. PLoS ONE |
| title | Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. |
| title_full | Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. |
| title_fullStr | Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. |
| title_full_unstemmed | Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. |
| title_short | Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. |
| title_sort | social and clinical predictors of short and long term readmission after a severe exacerbation of copd |
| url | https://doi.org/10.1371/journal.pone.0229257 |
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