Analysis Of Related Risk Factors For Readmission Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objectives:The aim of this study is to evaluate the association of risk factors with1 year of readmission for acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods:The study population included inpatients of the hospital from2018.01.01 to 2019.07.31 who were diagnosed with AECOPD.We systematically collect numerous variables,including general data;subsistence information;clinical data.All patients were followed up for one year to learn about the situation of readmission after the discharge.According to the patients’readmission treatment due to AECOPD within one year after the initial discharge,they were divided into readmission group and no readmission group.We compared the relevant indicators between the two groups,then used the multiple factors Binary Logistic regression equation to explore the association of risk factors with the readmission for AECOPD and construct a regression prediction model.AUC of ROC was used to evaluate discriminative ability of the model.Results:A total of 180 patients were inculuded in this study.Of these patients,78cases were readmitted to hospital after AECOPD,and the other 102 cases were not.1.Univariate analysis showed the following variables had such differences which were statistically significant between the two groups（readmission group and no-readmission group）:time of low-moderate-intensity physical activity of less than 2 hours（66.7%VS 43.1%,P=0.002）,BADLs score（91.41 VS 97.5,P=0.007）,and pulmonary hypertension（44.9%VS 27.5%,P=0.015）,home oxygen therapy（44.9%VS 28.4%,P=0.022）,antibiotic use time during hospitalization（10d VS 8d,P=0.026）,use of antibiotics containing enzyme inhibitors（61.5%VS40.2%,P=0.005）,FEV₁of the predicted value<50%（88.5%VS 76.5%,P=0.039）,frequency of exacerbation in the previous year≥2 times（32.1%VS 7.8%,P<0.001）,application of systemic glucocorticoids during hospitalization（52.6%VS37.3%,P=0.040）.2.The above 9 factors were incorporated into the binary multivariate logistic regression equation,and it was found that time of low-moderate-intensity physical activity of less than 2 hours（P=0.006）,FEV₁accounted for the percentage of predicted value（FEV₁%Pred）<50%（P=0.025）,and the frequency of exacerbation in the previous year≥2 times（P<0.001）were independently related to the risk of readmission for AECOPD.The predictive model constructed according to the logistic equation can correctly classify 67.6%of the study subjects.The sensitivity of predicting the readmission for AECOPD within 1 year after discharge is 71.8%,and the specificity is 64.4%.The area under the curve of the model is 0.725.Conclusion:1.Monitoring the FEV₁regularly can predict the risk of readmission of patients with AECOPD in the next year to a certain extent.2.Encouraging COPD patients to appropriately increase their daily activities on the premise of tolerability will help reduce the risk of re-hospitalization of patients with AECOPD.