在埃塞俄比亚，接受慢性阻塞性呼吸道疾病急性加重治疗的患者中早期再入院及其预测因素：一项前瞻性队列研究。

Early readmission and its predictors among patients treated for acute exacerbations of chronic obstructive respiratory disease in Ethiopia: A prospective cohort study.

机构信息

Clinical Pharmacy Unit, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

PLoS One. 2020 Oct 6;15(10):e0239665. doi: 10.1371/journal.pone.0239665. eCollection 2020.

BACKGROUND

Significant numbers of chronic obstructive respiratory disease patients are readmitted for Acute Exacerbation (AE) within 30 days of discharge. And these early readmissions have serious clinical and socioeconomic consequences. The objective of our study was to determine the rate of readmission within 30 days of discharge and it's predictors among patients treated for acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD).

METHODS

A prospective cohort study involving 130 patients (asthma = 59, COPD = 71) was conducted from April-September, 2019, in Jimma Medical Center (JMC), South-West Ethiopia. Socio-demographic, clinical, laboratory, and drug-related data were recorded at admission and during hospital stay. Cox regression analysis was performed to identify risk factors for readmissions following an AE of asthma and COPD.

RESULTS

During the study period, 130 (male, 78(60%)) patients were admitted with AE of asthma and COPD. The median age was 59(IQR, 50-70) years. Of 130 patients, 21(18.10%) had a new AE of asthma and COPD that required hospitalization in the 30 days after discharge. The overall median survival time to 30-day readmission was 20 days (IQR, 16-29). Multivariate analysis revealed prolonged use of oxygen therapy (AHR = 4.972, 95% CI [1.041-23.736] and frequent hospital admissions (AHR = 11.482 [1.308-100.793]) to be independent risk factors for early readmissions.

CONCLUSION

Early hospital readmission rates for AE of asthma and COPD were alarmingly high. Frequent hospital admission and long-term oxygen therapy during hospital stay were independent predictors of 30-day readmission.

背景

大量慢性阻塞性呼吸道疾病患者在出院后 30 天内因急性加重（AE）再次入院。这些早期再入院对临床和社会经济都有严重的后果。我们研究的目的是确定在因哮喘和慢性阻塞性肺疾病（COPD）急性加重而接受治疗的患者中，出院后 30 天内的再入院率及其预测因素。

方法

2019 年 4 月至 9 月，在埃塞俄比亚西南部吉马医疗中心（JMC）进行了一项前瞻性队列研究，共纳入 130 名患者（哮喘=59，COPD=71）。入院时和住院期间记录了社会人口统计学、临床、实验室和药物相关数据。采用 Cox 回归分析确定哮喘和 COPD 急性加重后再入院的危险因素。

结果

在研究期间，130 名（男性，78（60%））患者因哮喘和 COPD 急性加重而入院。中位年龄为 59（IQR，50-70）岁。在 130 名患者中，有 21 名（18.10%）因新的哮喘和 COPD 急性加重需要在出院后 30 天内住院治疗。总体中位至 30 天再入院时间为 20 天（IQR，16-29）。多变量分析显示，长时间使用氧气疗法（AHR=4.972，95%CI[1.041-23.736]）和频繁住院（AHR=11.482[1.308-100.793]）是早期再入院的独立危险因素。