Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study

Hong Wang,1,* Tao Yang,2,* Xiaodan Yu,3,* Zhihong Chen,4 Yajuan Ran,5 Jiajia Wang,6 Guangming Dai,1 Huojin Deng,7 Xinglong Li,8 Tao Zhu8 1Respiratory Medicine, First People’s Hospital of Suining City, Suining, 629000, Sichuan, People’s Republic of China; 2Thoracic Surgery, Fi...

Full description

Bibliographic Details
Main Authors: Wang H, Yang T, Yu X, Chen Z, Ran Y, Wang J, Dai G, Deng H, Li X, Zhu T
Format: Article
Language:English
Published: Dove Medical Press 2022-03-01
Series:International Journal of General Medicine
Subjects:
Online Access:https://www.dovepress.com/risk-factors-for-length-of-hospital-stay-in-acute-exacerbation-chronic-peer-reviewed-fulltext-article-IJGM
_version_ 1811332707117957120
author Wang H
Yang T
Yu X
Chen Z
Ran Y
Wang J
Dai G
Deng H
Li X
Zhu T
author_facet Wang H
Yang T
Yu X
Chen Z
Ran Y
Wang J
Dai G
Deng H
Li X
Zhu T
author_sort Wang H
collection DOAJ
description Hong Wang,1,&ast; Tao Yang,2,&ast; Xiaodan Yu,3,&ast; Zhihong Chen,4 Yajuan Ran,5 Jiajia Wang,6 Guangming Dai,1 Huojin Deng,7 Xinglong Li,8 Tao Zhu8 1Respiratory Medicine, First People’s Hospital of Suining City, Suining, 629000, Sichuan, People’s Republic of China; 2Thoracic Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 3Respiratory Medicine, Fifth People’s Hospital of Chengdu, Chengdu, 610000, Sichuan, People’s Republic of China; 4Respiratory Medicine, Zhongshan Hospital of Fudan University, Shanghai, 20032, People’s Republic of China; 5Pharmacy Department, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 6Rheumatology Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 7Respiratory Medicine, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510280, People’s Republic of China; 8Respiratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tao Zhu, Respiratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China, Tel +86 23 63693094, Email zhutao063020@163.comBackground/Purpose: A patient’s length of hospital stay (LHS) is associated with the severity and outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, identification of patients with prolonged LHS at an early stage can potentially reduce the risk of adverse events and treatment costs in patients with AECOPD. Therefore, this study aimed to explore the independent predictors of prolonged LHS in AECOPD patients.Patients and Methods: This multicenter cross-sectional study was conducted at two tertiary hospitals between January 2019 and August 2020. Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Univariate analysis was used to identify variables with significant differences. A collinearity diagnostic was applied to the selected variables before the establishment of the regression model. Ordinal logistic regression was performed to explore the independent risk factors for prolonged LHS in patients with AECOPD.Results: In total, 598 patients with AECOPD were screened. Finally, the LHS of 111, 218, and 100 patients was < 7, 7– 10, and ≥ 11 days, respectively. Significant differences in the 12 variables were found in the univariate analysis. Because collinearities among white blood cells (WBC), neutrophils (NS), and NS% were observed, WBC and NS% were excluded. Subsequently, an ordinal logistic regression model identified that rates of hypertension and chronic cor pulmonale (CCP), neutrophil–lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) were independent predictors of prolonged LHS in AECOPD patients.Conclusion: Collectively, our results showed that inflammatory status, hypertension, and CCP were independently associated with LHS in patients with AECOPD. These data indicate that early and appropriate administration of antibiotics and anti-inflammatory drugs is essential for reducing LHS. Hypertension and CCP were independent predictors of worse outcomes in patients with AECOPD. Therefore, advanced management and care should be provided to AECOPD patients with hypertension and/or CCP on admission.Keywords: acute exacerbation of chronic obstructive pulmonary disease, chronic cor pulmonale, erythrocyte sedimentation rate, hypertension, length of hospital stay, neutrophil–lymphocyte ratio
first_indexed 2024-04-13T16:40:07Z
format Article
id doaj.art-89e8009108b24469b19eaae9979b269b
institution Directory Open Access Journal
issn 1178-7074
language English
last_indexed 2024-04-13T16:40:07Z
publishDate 2022-03-01
publisher Dove Medical Press
record_format Article
series International Journal of General Medicine
spelling doaj.art-89e8009108b24469b19eaae9979b269b2022-12-22T02:39:15ZengDove Medical PressInternational Journal of General Medicine1178-70742022-03-01Volume 153447345874023Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional StudyWang HYang TYu XChen ZRan YWang JDai GDeng HLi XZhu THong Wang,1,&ast; Tao Yang,2,&ast; Xiaodan Yu,3,&ast; Zhihong Chen,4 Yajuan Ran,5 Jiajia Wang,6 Guangming Dai,1 Huojin Deng,7 Xinglong Li,8 Tao Zhu8 1Respiratory Medicine, First People’s Hospital of Suining City, Suining, 629000, Sichuan, People’s Republic of China; 2Thoracic Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 3Respiratory Medicine, Fifth People’s Hospital of Chengdu, Chengdu, 610000, Sichuan, People’s Republic of China; 4Respiratory Medicine, Zhongshan Hospital of Fudan University, Shanghai, 20032, People’s Republic of China; 5Pharmacy Department, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 6Rheumatology Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China; 7Respiratory Medicine, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510280, People’s Republic of China; 8Respiratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tao Zhu, Respiratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China, Tel +86 23 63693094, Email zhutao063020@163.comBackground/Purpose: A patient’s length of hospital stay (LHS) is associated with the severity and outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, identification of patients with prolonged LHS at an early stage can potentially reduce the risk of adverse events and treatment costs in patients with AECOPD. Therefore, this study aimed to explore the independent predictors of prolonged LHS in AECOPD patients.Patients and Methods: This multicenter cross-sectional study was conducted at two tertiary hospitals between January 2019 and August 2020. Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Univariate analysis was used to identify variables with significant differences. A collinearity diagnostic was applied to the selected variables before the establishment of the regression model. Ordinal logistic regression was performed to explore the independent risk factors for prolonged LHS in patients with AECOPD.Results: In total, 598 patients with AECOPD were screened. Finally, the LHS of 111, 218, and 100 patients was < 7, 7– 10, and ≥ 11 days, respectively. Significant differences in the 12 variables were found in the univariate analysis. Because collinearities among white blood cells (WBC), neutrophils (NS), and NS% were observed, WBC and NS% were excluded. Subsequently, an ordinal logistic regression model identified that rates of hypertension and chronic cor pulmonale (CCP), neutrophil–lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) were independent predictors of prolonged LHS in AECOPD patients.Conclusion: Collectively, our results showed that inflammatory status, hypertension, and CCP were independently associated with LHS in patients with AECOPD. These data indicate that early and appropriate administration of antibiotics and anti-inflammatory drugs is essential for reducing LHS. Hypertension and CCP were independent predictors of worse outcomes in patients with AECOPD. Therefore, advanced management and care should be provided to AECOPD patients with hypertension and/or CCP on admission.Keywords: acute exacerbation of chronic obstructive pulmonary disease, chronic cor pulmonale, erythrocyte sedimentation rate, hypertension, length of hospital stay, neutrophil–lymphocyte ratiohttps://www.dovepress.com/risk-factors-for-length-of-hospital-stay-in-acute-exacerbation-chronic-peer-reviewed-fulltext-article-IJGMacute exacerbation of chronic obstructive pulmonary diseasechronic cor pulmonaleerythrocyte sedimentation ratehypertensionlength of hospital stayneutrophil-lymphocyte ratio.
spellingShingle Wang H
Yang T
Yu X
Chen Z
Ran Y
Wang J
Dai G
Deng H
Li X
Zhu T
Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
International Journal of General Medicine
acute exacerbation of chronic obstructive pulmonary disease
chronic cor pulmonale
erythrocyte sedimentation rate
hypertension
length of hospital stay
neutrophil-lymphocyte ratio.
title Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
title_full Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
title_fullStr Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
title_full_unstemmed Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
title_short Risk Factors for Length of Hospital Stay in Acute Exacerbation Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
title_sort risk factors for length of hospital stay in acute exacerbation chronic obstructive pulmonary disease a multicenter cross sectional study
topic acute exacerbation of chronic obstructive pulmonary disease
chronic cor pulmonale
erythrocyte sedimentation rate
hypertension
length of hospital stay
neutrophil-lymphocyte ratio.
url https://www.dovepress.com/risk-factors-for-length-of-hospital-stay-in-acute-exacerbation-chronic-peer-reviewed-fulltext-article-IJGM
work_keys_str_mv AT wangh riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT yangt riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT yux riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT chenz riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT rany riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT wangj riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT daig riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT dengh riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT lix riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy
AT zhut riskfactorsforlengthofhospitalstayinacuteexacerbationchronicobstructivepulmonarydiseaseamulticentercrosssectionalstudy