Risk factors of readmission to hospital cor a COPD exacerbation: a prospective study

Garcia-Aymerch, J.; Farrero, E.; Félez, M. A.; Izquierdo, J.; Marrades, R. M.; Antó, J. M.
February 2003
Thorax;Feb2003, Vol. 58 Issue 2, p100
Academic Journal
Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are a leading cause of admission to hospital among men in many countries, although the factors causing exacerbations are largely unknown. The association between readmission for a COPD exacerbation and a wide range of modifiable potential risk factors, after adjusting for sociodemographic and clinical factors, has been assessed. Methods: Three hundred and forty patients with COPD recruited during an admission for an exacerbation in four tertiary hospitals in the Barcelona area of Spain were followed for a mean period of 1 .1 years. Information on potential risk factors, including clinical and functional status, medical care and prescriptions, medication adherence, lifestyle, health status, and social support, was collected at the recruitment admission. A Cox's proportional hazards model was used to obtain independent relative risks of readmission for COPD. Results: During the follow up period 63% of patients were readmitted at least once, and 29% died. The final multivariate model showed the following risk (or protective) factors: ⩾3 admissions for COPD in the year before recruitment (hazard ratio (HR)= 1 .66, 95% Cl 1 .16 to 2.39), forced expiratory volume in 1 second (FEV1) percentage predicted (0.97, 95% Cl 0.96 to 0.99), oxygen tension (0.88, 95% Cl 0.79 to 0.98), higher levels of usual physical activity (0.54, 95% Cl 0.34 to 0.86), and taking anticholinergic drugs (1 .81, 95% 1.11 to 2.94). Exposure to passive smoking was also related to an increased risk of readmission with COPD after adjustment for clinical factors (1 .63, 95% Cl 1 .04 to 2.57) but did not remain in the final model.


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