Exploring risk factors for all-cause hospital readmissions following chronic obstructive pulmonary disease exacerbation patients discharged on steroid tapers.

IF 2.1 3区 医学 Q3 RESPIRATORY SYSTEM
Journal of thoracic disease Pub Date : 2024-12-31 Epub Date: 2024-12-28 DOI:10.21037/jtd-24-932
Matthew Simpson, Rumbidzai Kapfumvuti, Sitara Niranjan, Matthew Sherman, Abdulahi Hassan, Erasmus Mutabi, Tyrell Daniel, Ravishankar Ranganatha, Kojo-Frimpong Awuah, Haris Paul, Yue Yin, Brandon Hoffman, Divya Venkat
{"title":"Exploring risk factors for all-cause hospital readmissions following chronic obstructive pulmonary disease exacerbation patients discharged on steroid tapers.","authors":"Matthew Simpson, Rumbidzai Kapfumvuti, Sitara Niranjan, Matthew Sherman, Abdulahi Hassan, Erasmus Mutabi, Tyrell Daniel, Ravishankar Ranganatha, Kojo-Frimpong Awuah, Haris Paul, Yue Yin, Brandon Hoffman, Divya Venkat","doi":"10.21037/jtd-24-932","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) exacerbations often lead to hospitalizations and subsequent readmissions. Steroid therapy is a common approach in managing COPD exacerbations, yet a considerable proportion of patients experience readmissions within a short timeframe, highlighting the persistent and complex nature of COPD exacerbations. The aim of this retrospective study is to investigate risk factors for all-cause hospital readmissions in COPD patients discharged on steroid tapers following exacerbations, emphasizing the need for personalized management strategies to reduce readmission rates.</p><p><strong>Methods: </strong>Patient demographics and treatment histories were collected in a retrospective study of electronic medical records for patients in our hospital system for the calendar year 2023. Descriptive statistics were calculated, and univariate logistic regression were conducted for potential predictors.</p><p><strong>Results: </strong>Data analysis revealed that higher exacerbation frequency significantly increased the likelihood of readmission within a year, with patients experiencing three or more exacerbations facing 11 times and 25 times greater risks compared to those with 0 exacerbations. Early re-exacerbations within 30 days of discharge also emerged as strong predictors of long-term prognosis.</p><p><strong>Conclusions: </strong>Existing prognostic tools lack specificity for predicting short-term readmissions, highlighting the need for comprehensive risk assessment tools tailored to individual patient needs. Proactive monitoring of exacerbation frequency and personalized management strategies are essential for optimizing care delivery and reducing readmission rates in COPD patients. Targeted interventions aimed at mitigating identified risk factors and optimizing post-discharge management can enhance patient outcomes and alleviate the overall burden of COPD on patients and healthcare systems. Further research is warranted to address limitations and refine risk assessment tools to support personalized COPD care.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8538-8549"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740058/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-24-932","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Chronic obstructive pulmonary disease (COPD) exacerbations often lead to hospitalizations and subsequent readmissions. Steroid therapy is a common approach in managing COPD exacerbations, yet a considerable proportion of patients experience readmissions within a short timeframe, highlighting the persistent and complex nature of COPD exacerbations. The aim of this retrospective study is to investigate risk factors for all-cause hospital readmissions in COPD patients discharged on steroid tapers following exacerbations, emphasizing the need for personalized management strategies to reduce readmission rates.

Methods: Patient demographics and treatment histories were collected in a retrospective study of electronic medical records for patients in our hospital system for the calendar year 2023. Descriptive statistics were calculated, and univariate logistic regression were conducted for potential predictors.

Results: Data analysis revealed that higher exacerbation frequency significantly increased the likelihood of readmission within a year, with patients experiencing three or more exacerbations facing 11 times and 25 times greater risks compared to those with 0 exacerbations. Early re-exacerbations within 30 days of discharge also emerged as strong predictors of long-term prognosis.

Conclusions: Existing prognostic tools lack specificity for predicting short-term readmissions, highlighting the need for comprehensive risk assessment tools tailored to individual patient needs. Proactive monitoring of exacerbation frequency and personalized management strategies are essential for optimizing care delivery and reducing readmission rates in COPD patients. Targeted interventions aimed at mitigating identified risk factors and optimizing post-discharge management can enhance patient outcomes and alleviate the overall burden of COPD on patients and healthcare systems. Further research is warranted to address limitations and refine risk assessment tools to support personalized COPD care.

探索慢性阻塞性肺疾病加重患者服用类固醇药物出院后全因再入院的危险因素。
背景:慢性阻塞性肺疾病(COPD)恶化经常导致住院和随后的再入院。类固醇治疗是治疗慢性阻塞性肺病加重的常用方法,但相当一部分患者在短时间内再次入院,这突出了慢性阻塞性肺病加重的持久性和复杂性。本回顾性研究的目的是调查COPD患者急性加重后使用类固醇减量药物出院的全因再入院的危险因素,强调需要个性化的管理策略来降低再入院率。方法:对我院2023历年患者电子病历进行回顾性研究,收集患者人口统计资料和治疗史。计算描述性统计,并对潜在的预测因子进行单变量逻辑回归。结果:数据分析显示,较高的急性发作频率显著增加了一年内再入院的可能性,与0次急性发作的患者相比,3次及以上急性发作的患者面临的风险分别高出11倍和25倍。出院30天内早期再恶化也成为长期预后的有力预测因素。结论:现有的预后工具在预测短期再入院方面缺乏特异性,因此需要针对患者个体需求量身定制的综合风险评估工具。主动监测加重频率和个性化管理策略对于优化护理服务和降低COPD患者再入院率至关重要。旨在减轻已确定的危险因素和优化出院后管理的有针对性的干预措施可以提高患者的预后,减轻COPD对患者和医疗保健系统的总体负担。需要进一步的研究来解决局限性和完善风险评估工具,以支持个性化的COPD护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of thoracic disease
Journal of thoracic disease RESPIRATORY SYSTEM-
CiteScore
4.60
自引率
4.00%
发文量
254
期刊介绍: The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信