与慢性阻塞性肺疾病早期再入院相关的危险因素。
Risk factors associated with chronic obstructive pulmonary disease early readmission.
作者信息
Lin Jian, Xu Youzu, Wu Xiaomai, Chen Meifang, Lin Ling, Gong Liuyang, Feng Jiaxi
机构信息
Department of Respiratory Medicine, Taizhou Hospital of Wenzhou Medical University , Linhai, Zhejiang , P.R. China.
出版信息
Curr Med Res Opin. 2014 Feb;30(2):315-20. doi: 10.1185/03007995.2013.858623. Epub 2013 Nov 7.
BACKGROUND
The 31 day readmission rate is deemed to be an important indicator of the quality of medical care in China. The objectives of this study were to identify the readmission rate of acute exacerbation for chronic obstructive pulmonary disease (COPD) and to evaluate associated risk factors.
METHODS
We retrospectively reviewed charts for patients with acute exacerbation of COPD (AECOPD) admitted to our hospital between January 2011 and November 2012. The early-readmission group and non-early-readmission group were determined by whether patients were readmitted within 31 days after discharge. Logistic regression analysis was performed to identify risk factors for early readmission following an AECOPD.
RESULTS
There were 692 patients with 925 admissions during the 23 month period; 63 (6.8%) admissions met our criteria for early readmission. Multivariate analysis showed that chronic cor pulmonale (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.26-3.64, p = 0.005), hypoproteinemia (OR 2.02, 95% CI 1.03-3.95, p = 0.040) and an elevated PaCO2 (OR 1.03, 95% CI 1.00-1.06, p = 0.027) were identified as risk factors for early readmission of AECOPD.
CONCLUSION
The readmission rate for AECOPD was 6.8%. AECOPD patients with chronic cor pulmonale, hypoproteinemia, and a high PaCO2 are at higher risk for readmission with 31 days of hospital discharge, and medical care of these patients warrants greater attention.
背景
31天再入院率被认为是中国医疗质量的一项重要指标。本研究的目的是确定慢性阻塞性肺疾病(COPD)急性加重的再入院率,并评估相关危险因素。
方法
我们回顾性分析了2011年1月至2012年11月期间我院收治的COPD急性加重(AECOPD)患者的病历。根据患者出院后31天内是否再次入院确定早期再入院组和非早期再入院组。进行逻辑回归分析以确定AECOPD后早期再入院的危险因素。
结果
在这23个月期间,共有692例患者入院925次;63次(6.8%)入院符合我们的早期再入院标准。多变量分析显示,慢性肺源性心脏病(优势比[OR]2.14,95%置信区间[CI]1.26 - 3.64,p = 0.005)、低蛋白血症(OR 2.02,95%CI 1.03 - 3.95,p = 0.040)和动脉血二氧化碳分压(PaCO2)升高(OR 1.03,95%CI 1.00 - 1.06,p = 0.027)被确定为AECOPD早期再入院的危险因素。
结论
AECOPD的再入院率为6.8%。患有慢性肺源性心脏病、低蛋白血症和高PaCO2的AECOPD患者出院31天内再次入院的风险较高,这些患者的医疗护理值得更多关注。