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":"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。","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":"{\"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}","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}
Exploring risk factors for all-cause hospital readmissions following chronic obstructive pulmonary disease exacerbation patients discharged on steroid tapers.
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.
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.