Wang Qing, Pei Guangsheng, Chen Lin, He Zhiyi
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
Ann Transl Med. 2022 Feb;10(4):175. doi: 10.21037/atm-22-150.
Patients with chronic obstructive pulmonary disease (COPD) are often readmitted to hospital for treatment due to an acute exacerbation of the disease. However, there are few up-to-date studies investigating the lengths of stay and risk factors for readmission after an acute exacerbation of COPD. This study evaluated the length of stay in patients with an acute exacerbation of COPD and the factors that influenced their readmission.
A search of the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases, carried out using the following search terms: airflow limitation, airway disease, airway obstruction, chronic obstructive pulmonary disease, COPD, length of stay and influencing factors, long-term oxygen therapy, lung disease, readmission, and respiratory system disease. The Cochrane risk of bias tool was used to evaluate the quality of the retrieved studies, and a network meta-analysis was performed using RevMan 5.20.
Collectively, they included information on the length of stay for 630 patients who had been readmitted to hospital after an acute exacerbation of COPD (the readmitted group) and information on 688 patients who had not been readmitted (the non-readmitted group). Meta-analysis results showed that there was no difference in patient anxiety [risk ratio (RR) 1.22, 95% confidence interval (CI): 0.70-2.14] or long-term oxygen therapy (RR 1.91, 95% CI: 0.98-3.73) between the readmitted group and the non-readmitted group. However, there was a significant difference between the forced expiratory volume in one second (FEV1) predicted value [mean difference (MD) -5.85, 95% CI: -11.14 to -0.57] and the global initiative for chronic obstructive lung disease (GOLD) classification (C or D) (RR 1.61, 95% CI: 1.05-2.47).
In summary, no significant relationship was found between patient state of anxiety, long-term oxygen therapy, length of hospital stay, and readmission rate after an acute exacerbation of COPD. However, FEV1 predicted values and GOLD classifications (C or D) had an impact on the length of hospital stay and readmission rate after acute exacerbation of COPD. Larger samples, multiple centers, and further research are needed to confirm the findings of this research.
慢性阻塞性肺疾病（COPD）患者常因疾病急性加重而再次入院治疗。然而，目前鲜少有最新研究调查COPD急性加重后的住院时长及再入院风险因素。本研究评估了COPD急性加重患者的住院时长以及影响其再入院的因素。
使用以下检索词对PubMed、Cochrane对照试验中心注册库、Embase、科学网、中国知网（CNKI）、万方和维普数据库进行检索：气流受限、气道疾病、气道阻塞、慢性阻塞性肺疾病、COPD、住院时长及影响因素、长期氧疗、肺部疾病、再入院和呼吸系统疾病。采用Cochrane偏倚风险工具评估检索到的研究的质量，并使用RevMan 5.20进行网络荟萃分析。
总体而言，它们纳入了630例COPD急性加重后再次入院患者（再入院组）的住院时长信息以及688例未再入院患者（未再入院组）的信息。荟萃分析结果显示，再入院组与未再入院组在患者焦虑程度[风险比（RR）1.22，95%置信区间（CI）：0.70 - 2.14]或长期氧疗（RR 1.91，95% CI：0.98 - 3.73）方面无差异。然而，一秒用力呼气容积（FEV1）预测值[平均差（MD） - 5.85，95% CI： - 11.14至 - 0.57]与慢性阻塞性肺疾病全球倡议（GOLD）分级（C或D）（RR 1.61，95% CI：1.05 - 2.47）之间存在显著差异。
总之，未发现COPD急性加重后患者焦虑状态、长期氧疗、住院时长和再入院率之间存在显著关联。然而，FEV1预测值和GOLD分级（C或D）对COPD急性加重后的住院时长和再入院率有影响。需要更大样本、多中心及进一步研究来证实本研究结果。
