Obstructive Lung Diseases |

Predictors of Early Readmission Among Patients Hospitalized With Chronic Obstructive Pulmonary Disease FREE TO VIEW

Roozbeh Sharif, MD; Trisha Parekh, DO; Yong-Fang Kuo, PhD; Gulshan Sharma, MD
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University of Texas Medical Branch, Galveston, TX

Chest. 2014;145(3_MeetingAbstracts):420A. doi:10.1378/chest.1722770
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SESSION TYPE: Slide Presentations

PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:00 AM

PURPOSE: Little is known about hospital readmission among patients <65 years hospitalized with Chronic Obstructive Pulmonary Disease (COPD). We aimed to determine the frequency and predictors of early readmission (within 30 days of discharge) among this population.

METHODS: In a retrospective cohort study, clinical data were obtained from a private health insurance beneficiaries. Hospitalized patients with primary discharge diagnosis of COPD from 2009 to 2011 were included. Patients >65 years old were excluded. Clinical information over 12 months prior to the index hospitalization and within 30 day after discharge was obtained. Primary outcome was early readmission, defined as re-hospitalization within 30 days. We compared patient, provider, and system factors between patients who were readmitted and those who were not. Logistic regression model was used for multivariable analysis.

RESULTS: Of 8,263 patients included in the study, 741 (8.9%) were readmitted within 30 days. Multivariable analysis showed that history of heart failure, lung cancer, anxiety, depression, and osteoporosis, and hospital stay <3 or >7 days were associated with higher likelihood of early readmission (Odds ratio [OR] of 1.19, 1.52, 1.22, 1.20, 1.34, 1.18, and 1.29, respectively; p<0.05). Female sex, prescription of Statins within 12 months prior to admission, prescription of bronchodilator, oral steroid, and antibiotics upon discharge and follow-up appointment after discharge correlated with lower odds of early readmission (OR of 0.85, 0.75, 0.75. 0.59, 0.85, and 0.87, respectively; p<0.05).

CONCLUSIONS: One out of 11 patients hospitalized with COPD was readmitted within 30 days after discharge. An array of patient (presence of comorbid conditions), provider (lack of prescription of Statin prior to hospitalization and lack of prescription of short-acting inhaler, oral steroid and antibiotics upon discharge), and system (very short or prolong length of stay during index hospitalization and lack of follow-up visit) factors correlated with early readmission among patients hospitalized with COPD.

CLINICAL IMPLICATIONS: Treating comorbid conditions and improving care transition processes after discharge may reduce early readmissions in patients <65 years old hospitalized with COPD.

DISCLOSURE: The following authors have nothing to disclose: Roozbeh Sharif, Trisha Parekh, Yong-Fang Kuo, Gulshan Sharma

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