Abstract
Introduction: COPD affects 12 million Americans and is one of the leading causes of death worldwide. The national data on COPD readmission rate is about 20% in the U.S. Patients are usually admitted for acute exacerbation with acute or chronic respiratory failure, albeit many were admitted with other comorbidities rather than COPD acute exacerbation. The purpose of this study was to identify high index comorbidities that contribute to COPD hospital readmissions.
Method: Retrospective analysis of a large database on COPD patients who were admitted from 01/01/2013 to 12/31/2015 to a major university health care system in the Southeastern United States was used for this study. Information on patient demographics, medical problems, medications, COPD admissions and readmissions was collected. The Charlson Comorbidity Index (CCI) was used for identifying comorbidities.
Results: The common comorbidities identified in patients who were admitted and re-admitted included congestive heart failure (41.5%), diabetes without complications (33.6%), and renal disease (31.4%). Higher hemoglobin and albumin levels were inversely related to 30-day readmission.
Conclusion: Patients admitted with COPD exacerbation had co-morbidities which included heart failure, diabetes, renal disease, and other diseases sharing the pathophysiology of chronic inflammatory processes. Therefore, we recommend that COPD management should be comprehensive in monitoring chronic inflammatory processes and optimizing management of co-morbidities in addition to the improvement of pulmonary function and lung health.