Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Sci Rep. 2022 Oct 5;12(1):16589. doi: 10.1038/s41598-022-20884-3.
Readmission due to chronic obstructive pulmonary disease (COPD) exacerbation contributes significantly to disease burden. Trend in readmission rate among COPD patients in China is not well characterized. We described the secular trend and identify risk factors of COPD-related 30-day readmission in Beijing during 2012-2017. In this retrospective cohort study, we used data from a citywide hospital discharge database in Beijing. We included patients ≥ 40 years with a primary diagnosis of COPD from 2012 to 2017. A total of 131 591 index admissions were identified. COPD-related 30-day readmission was defined as the initial admission with a primary diagnosis of COPD that occurs within 30 days from the discharge date of an index admission. Overall and annual 30-day readmission rates were calculated in the total population and subgroups defined by patient characteristics. We used multivariable logistic models to investigate risk factors for readmission and in-hospital mortality within 30 days. The overall 30-day COPD-related readmission rate was 15.8% (n = 20 808). The readmission rate increased from 11.5% in 2012 to 17.2% in 2017, with a multivariable-adjusted OR (95% CI) for annual change to be 1.08 (1.06-1.09) (P trend < 0.001). The upward trend in readmission rate levelled off at about 17% since 2014. The readmission rate of men was higher and increased faster than women. Comorbid osteoporosis, coronary heart disease, congestive heart failure, and cancer were associated with an increased risk of 30-day COPD-related readmission. The 30-day COPD-related readmission rate in Beijing showed an overall increasing trend from 2012 to 2017. Future efforts should be made to further improve care quality and reduce early readmissions of COPD patients.
慢性阻塞性肺疾病（COPD）恶化导致的再入院对疾病负担的影响很大。中国 COPD 患者的再入院率趋势尚不清楚。本研究旨在描述 2012-2017 年北京 COPD 患者的时间变化趋势，并确定 COPD 相关 30 天再入院的危险因素。在这项回顾性队列研究中，我们使用了北京市全市医院出院数据库的数据。我们纳入了 2012 年至 2017 年期间≥40 岁且主要诊断为 COPD 的患者。共确定了 131591 例指数入院。COPD 相关 30 天再入院定义为出院日期后 30 天内因 COPD 初始入院的主要诊断。在总人群和按患者特征定义的亚组中计算了 COPD 相关 30 天再入院的总体和年度再入院率。我们使用多变量逻辑模型来调查 30 天内再入院和住院死亡率的危险因素。总体 COPD 相关 30 天再入院率为 15.8%（n=20808）。再入院率从 2012 年的 11.5%增加到 2017 年的 17.2%，多变量调整后的年度变化比值比（95%CI）为 1.08（1.06-1.09）（P趋势<0.001）。自 2014 年以来，再入院率的上升趋势趋于平稳，约为 17%。男性的再入院率高于女性，且上升速度更快。合并骨质疏松症、冠心病、充血性心力衰竭和癌症与 COPD 相关 30 天再入院风险增加相关。2012 年至 2017 年，北京 COPD 相关 30 天再入院率呈总体上升趋势。未来应努力进一步提高 COPD 患者的护理质量，减少早期再入院。
