The rate of 30-day index readmissions after acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is 19.2%, according to a study published in the July issue of the Annals of the American Thoracic Society.
David M. Jacobs, Pharm.D., Ph.D., from the University of Buffalo in New York, and colleagues analyzed the Nationwide Readmission Database from 2013 to 2014 to determine the rates, causes and predictors for early readmission in patients hospitalized with AECOPD.
After 1,055,830 index AECOPD admissions, the researchers identified 202,300 30-day readmissions, for a rate of 19.2%. The highest rates of readmission were seen within the first 72 hours of discharge (4.2 to 5.5%); more than half of readmissions (58%) were within the first 15 days.
The most common reason for readmission was respiratory-based diseases (52.4%), with COPD the most common diagnosis (28.4%). At different time periods after discharge, the readmission diagnoses were similar.
Readmission after discharge
There were correlations for early readmission with patient factors (Medicaid payer status, lower household income, and higher comorbidity burden) and clinical factors (longer length of stay and discharge to a skilled nursing facility). Within the 30-day window, predictors did not vary substantially by the time of readmission after discharge.
"Development of a COPD-specific risk stratification algorithm based on these factors may be necessary to better predict patients with AECOPD at high risk of early readmission," the authors write.