Risk factors resulting early readmissions after discharge of COPD exacerbations

Aim : COPD is an important disease of the wholeworld causing high morbidity in mortality now a days.It is known that readmissions and frequent hospitalizations shortens the survival of patients with COPD. In this study, we aimed to determine the possible risk factors of early readmissions of COPD exacerbated patients in the first 30 days after discharge. Material and Method: In this study, 54 COPD patients, over 40 years of age who admitted to Çukurova University Department of Chest Diseases between September 2015- January 2016 and hospitalized for exacerbation of the disease enrolled regardless of the smoking status.The COPD-related readmissions of the participants in the first thirty days after discharge recorded in order to determine the possible reasons of early readmissions. After signature of informed consent form, each participant filled the survey form concerning about detailed comorbidities and medical history. Furthermore, some other potentially related factors as pulmonary function tests reflecting the severity of air flow limitation, arterial blood gas analysis, mMRC-ADO-DOSE indexes and detailed history of hospital stay and the first thirty days after discharge recorded .The participants have been followed up for a month about redmissions. Results : 13 (24,1%) of 54 patients readmitted to hospital in the first thirty days after discharge. The mean age of the patients was 64,24±9,95 and 84,6% were male. The early readmitted group's mean age was higher than then on-readmitted group but the difference wasn't statistically significant. Charlson comorbidity index scores, frequency of lung cancer, moderate-severe kidney disease, WBC count, socioeconomic status and metastatic solid tumors were significantly higher in the early readmitted group than the other group(respectively P=0,029, P=0,012, P=0,015, P=0,01, P=0,057 and P=0,024). Postbronchodilator FEV1/FVC level of there admitted group was lower than then on-readmitted group and the difference was statistically significant. Multivariate regression analysis showed that Charlson comorbidity index scores and body mass index were significant risk factors of early readmissions for first thirty days after discharge. Conclusion: In this study; comorbidities, serum WBC counts and socioeconomic factos were found to be related with increased early readmissions. These results were consistent with many other studies. Our study showed no significant association between some other probable risk factors as COPD severity and COPD early readmissions; this may be the result of small patient population and short duration of the follow-up. Thus, further studies with larger populutions are needed in order toclarify about this topic.