Abstract:
Background:Thirty-day readmission in COPD is common and costly, but potentially preventable. The emergency department (ED) may be a setting for COPD readmission reduction efforts. Objective:To better understand COPD readmission through the ED, ascertain factors associated with 30-day readmission through the ED, and identify subgroups of patients with COPD for readmission reduction interventions. Patients and methods:A retrospective cohort study was conducted from January 2009 to September 2015 in patients with COPD of age ≥18 years. Electronic health record data were abstracted for information available to admitting providers in the ED. The primary outcome was readmission through the ED within 30 days of discharge from an index admission for COPD. Logistic regression was used to examine the relationship between potential risk factors and 30-day readmission. Results:The study involved 1,574 patients who presented to the ED within 30 days on an index admission for COPD. Of these, 82.2% were readmitted through the ED. Charlson score (odds ratio [OR]: 3.6; 95% CI: 2.9-4.4), a chief complaint of breathing difficulty (OR: 1.6; 95% CI: 1.1-2.6), outpatient utilization of albuterol (OR: 4.1; 95% CI: 2.6-6.4), fluticasone/salmeterol (OR: 2.3; 95% CI: 1.3-4.2), inhaled steroids (OR: 3.8; 95% CI: 1.3-10.7), and tiotropium (OR: 1.8; 95% CI: 1.0-3.2), as well as arterial blood gas (OR: 4.4; 95% CI: 1.3-15.1) and B-type natriuretic peptide (OR: 2.2; 95% CI: 1.4-3.5) testing in the ED were associated with readmission (c-statistic =0.936). Seventeen-point-eight percent of patients with COPD presented to the ED and were discharged home; 56% presented with a complaint other than breathing difficulty; and 16% of those readmitted for breathing difficulty had a length of stay <48 hours. Conclusion:Intensive outpatient monitoring, evaluation, and follow-up after discharge are needed to help prevent re-presentation to the ED, as practically all patients with COPD who represent to the ED within 30 days are readmitted to the hospital and for a variety of clinical complaints. Among those patients with COPD who present with breathing difficulty, improved decision support algorithms and alternative management strategies are needed to identify and intervene on the subgroup of patients who require <48-hour length of stay.
journal_name
Int J Chron Obstruct Pulmon Disauthors
Rezaee ME,Ward CE,Nuanez B,Rezaee DA,Ditkoff J,Halalau Adoi
10.2147/COPD.S147796subject
Has Abstractpub_date
2017-12-27 00:00:00pages
109-120eissn
1176-9106issn
1178-2005pii
copd-13-109journal_volume
13pub_type
杂志文章abstract::Background: There are currently limited real-world data on the clinical burden of illness in patients with COPD who continue to exacerbate despite receiving triple therapy. The aim of this study was to compare the burden of COPD in patients with and without a phenotype characterized by a high blood eosinophil count an...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S194511
更新日期:2019-03-28 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It is known that biomarkers of systemic inflammation are raised in COPD caused by tobacco (T-COPD) compared with healthy controls, but there is less information on the inflammatory status of subjects with COPD caused by biomass smoke (B-COPD). In addition, the possible (if any) differences in i...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S141068
更新日期:2017-09-01 00:00:00
abstract:Background:Chronic obstructive pulmonary disease (COPD) is an age-related disease, and its incidence rate is increasing every year. MicroRNAs (miRNAs) play critical roles in the COPD process and function as key biomarkers or potential therapeutic targets for patients with COPD. However, the potential roles and function...
journal_title:International journal of chronic obstructive pulmonary disease
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doi:10.2147/COPD.S278553
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:Management of chronic incurable diseases such as chronic obstructive pulmonary disease (COPD) and asthma is difficult. Incorporation of patient preferences is widely encouraged. PURPOSE:To summarize original research articles determining patient preference in moderate-to-severe disease. METHODS:Acceptable ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S82179
更新日期:2015-04-08 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) experience respiratory symptoms, which impair quality of life. This pooled analysis of two Phase III studies assessed the impact of aclidinium/formoterol on patients with COPD categorized by symptom status. METHODS:Data were pooled from two 24-week,...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S114566
更新日期:2016-08-29 00:00:00
abstract:OBJECTIVE:To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation. METHODS:Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,随机对照试验
doi:10.2147/copd.s6643
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND AIM:Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION:This trial is registered with the Netherlands Trial Register, NTR4037. ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2147/COPD.S141974
更新日期:2017-09-28 00:00:00
abstract::Clinical trials of a combination therapy of an inhaled corticosteroid, fluticasone propionate (FP), with a long-acting beta2-agonist, salmeterol (Sal), have demonstrated a greater improvement in lung function and in quality of life measures after the combination compared with either component of alone. In a subanalysi...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/copd.2006.1.3.235
更新日期:2006-01-01 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S188994
更新日期:2018-12-28 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S36997
更新日期:2012-01-01 00:00:00
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更新日期:2017-02-24 00:00:00
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pub_type: 杂志文章
doi:10.2147/COPD.S182504
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abstract:BACKGROUND:Noncommunicable diseases have become a public heath problem in India concomitant with economic development, leading to increases in tobacco consumption, obesity, and changes in diet and lifestyle. Although observation suggests that tobacco consumption is a major risk factor for deaths due to circulatory, pul...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-10-11 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 临床试验,杂志文章
doi:10.2147/COPD.S85744
更新日期:2015-07-29 00:00:00
abstract::Abstract: Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT...
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pub_type: 杂志文章
doi:10.2147/copd.s1822
更新日期:2008-01-01 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
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doi:10.2147/COPD.S182802
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/copd.s1516
更新日期:2008-01-01 00:00:00
abstract::[This corrects the article on p. 1401 in vol. 12, PMID: 28546748.]. ...
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doi:10.2147/COPD.S80439
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
doi:10.2147/COPD.S253567
更新日期:2020-07-10 00:00:00
abstract:PURPOSE:There are still evidence gaps on the prevalence of airflow limitation in Japan. The purpose of this survey was to estimate the prevalence of airflow limitation among healthy subjects in Japan and to show what proportion of subjects with airflow limitation had been diagnosed with chronic obstructive pulmonary di...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究
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更新日期:2016-04-22 00:00:00
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pub_type: 杂志文章
doi:10.2147/COPD.S136256
更新日期:2017-10-06 00:00:00
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journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-09-07 00:00:00
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pub_type: 杂志文章
doi:10.2147/COPD.S164431
更新日期:2018-05-31 00:00:00
abstract:BACKGROUND:The clinical efficacy and safety of a mometasone furoate/formoterol fumarate (MF/F) fixed-dose combination formulation administered via a metered-dose inhaler was investigated in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). METHODS:Two 52-week, multicenter, double-blin...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2147/COPD.S29444
更新日期:2012-01-01 00:00:00
abstract:Rationale:Individual socioeconomic status has been shown to influence the outcomes of patients with chronic obstructive pulmonary disease (COPD). However, contextual factors may also play a role. The objective of this study is to evaluate the association between neighborhood socioeconomic disadvantage measured by the a...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S238933
更新日期:2020-05-05 00:00:00