Obstructive Lung Diseases |

COPD Exacerbations: Causes for Rehospitalization Within a 30 Day Period FREE TO VIEW

Brian Carlin, MD; Dan Easley, BS; Kim Wiles, RRT
Author and Funding Information

Sleep Medicine and Lung Health Consultants, Ingomar, PA

Chest. 2013;144(4_MeetingAbstracts):702A. doi:10.1378/chest.1704884
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SESSION TITLE: COPD Diagnosis & Evaluation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: The overall 30 day readmission rate for patients with COPD following hospitalization for an exacerbation approaches 25% in many areas of the United States. Patients with COPD often have several associated comorbid conditions that may play a role in such rehospitalizations. The purpose of this study was to evaluate the cause for readmission to the hospital within a 30 day period following discharge for those patients who had had a COPD exacerbation and who were entered into a respiratory therapist driven transition of care program.

METHODS: The Discharge, Assessment and Summary @ Home (D.A.S.H., Klingensmith HealthCare) program was implemented for patients with COPD who required supplemental oxygen use following hospital discharge. The program consists of face-to-face visits by a respiratory therapist with the patient in the home environment on days 2 and 30 following hospital discharge. Phone interviews by a care coordinator are then conducted in between these visits. Education, behavior modification, skills training, oxygen titration during performance of activities of daily living, clinical assessment, and adherence data collection are key components of the program. The cause for readmission to the hospital within the 30 days post hospitalization was studied.

RESULTS: From January 1, 2012 through March 12, 2013, 407 patients with a diagnosis or history of COPD were entered into the transition of care program. Thirty patients (7.4%) were readmitted to the hospital within the thirty days following hospital discharge. Nineteen patients (63%) were readmitted due to either the original or a commonly associated comorbid condition (COPD, congestive heart failure, pneumonia, ‘unknown’ cause for dyspnea, or falls) while eleven (37%) were readmitted for other causes (renal failure, nephrolithiasis, pulmonary embolism, urinary tract infection, change in mental status, poor compliance with therapy).

CONCLUSIONS: For those patients completing this transition of care program, a significant percentage (37%) were readmitted for causes other than those associated typically with the patient's COPD.

CLINICAL IMPLICATIONS: Other illnesses, apart from those commonly associated with COPD, should be considered in patients with COPD who are being discharged from the hospital as potential causes for readmission.

DISCLOSURE: Dan Easley: Employee: Employee of Klingensmith Health Care Kim Wiles: Employee: Employee of Klingensmith Healthcare The following authors have nothing to disclose: Brian Carlin

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