Decreasing Hospital Readmissions Utilizing an Evidence-Based COPD Care Bundle

Kendra, Moira; Mansukhani, Rupal Patel; Rudawsky, Nicole; Landry, Lisa; Reyes, Natalie; Chiu, Stephanie; Daley, Brittney; Markley, Daniel; Fetherman, Brandee; Dimitry, Edward A; Cerrone, Federico; Shah, Chirag V.

doi:10.1007/s00408-022-00548-9

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Improving access to primary health care and providing care bundles (including consults, inpatient interventions, education, transitions of care, and after discharge care) are effective strategies to decrease hospital readmissions. 46 Furthermore, the impact of COVID-19 among AECOPD patients should be interpreted. According to a meta analysis including 13 studies assessing the influence of COVID-19 on readmission rates among AECOPD patients, age is the most dominant risk factor for readmission rate, followed by diabetes, high LOS, COPD, chronic kidney disease, liver disease, metastatic disease and coronary artery disease, and COVID-19 was not superior to them.…”

Section: Discussionmentioning

confidence: 99%

Association of Blood Inflammatory Biomarkers with Clinical Outcomes in Patients with AECOPD: An 8-Year Retrospective Study in Beijing

Shao¹,

Zhang²,

Feng³

et al. 2023

COPD

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Purpose To discover potential inflammatory biomarkers, which can compare favorably with traditional biomarkers, and their best cut-offs at first admission to predict clinical outcomes (short-term and long-term) and the risk of readmission among acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients. Patients and Methods Novel inflammatory biomarkers (such as the neutrophil–lymphocyte ratio [NLR], platelet–lymphocyte ratio [PLR], etc.) were compared with traditional biomarkers by Pearson’s correlation test. Logistic regression analysis and receiver operating characteristic (ROC) curves were applied to judge the accuracy of these novel biomarkers to predict in-hospital mortality. Results Surviving AECOPD patients had lower NLR, PLR, and lymphocyte-to-monocyte ratios than non-survival patients (all P < 0.001). According to Pearson’s correlation test, there was a linear correlation between novel and traditional biomarkers (all P < 0.05). In terms of a single biomarker, the AUC value of NLR was the largest, which was not inferior to C-reactive protein (Z-P = 0.064), and superior to erythrocyte sedimentation rate (Z-P = 0.002) and other novel single inflammatory biomarkers (all Z-P < 0.05). The mortality of patients with NLR ≥ 4.43 was 2.308-fold higher than that of patients with NLR < 4.43. After dividing patients into a higher or lower NLR group, pooled results showed that patients with NLR ≥ 4.43 had a higher rate of treatment failure, intensive care unit admission, longer hospital length of stay, one-year mortality after the index hospitalization, and overall mortality than patients with NLR < 4.43 (all P < 0.001). Patients with NLR ≥ 4.43 were associated with higher and earlier first readmission due to AECOPD than patients with lower NLR. Conclusion NLR was the best to forecast the clinical prognosis and readmission risk among AECOPD patients, which was not inferior to CRP, and the best cut-off value of NLR was 4.43.

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Section: Discussionmentioning

confidence: 99%

Association of Blood Inflammatory Biomarkers with Clinical Outcomes in Patients with AECOPD: An 8-Year Retrospective Study in Beijing

Shao¹,

Zhang²,

Feng³

et al. 2023

COPD

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LUNG Year in Review: 2022

Dicpinigaitis

2023

Lung

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Effect of a nurse-led integrated care intervention on quality of life and rehospitalisation in patients with severe exacerbation of COPD—a pilot study

Schmid-Mohler,

Hübsch,

Braun

et al. 2024

Chron Respir Dis

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Objective To explore the feasibility and effect of a nurse-led integrated care intervention on health-related quality of life (QoL) and unplanned 90-day rehospitalisation in patients hospitalised due to acute exacerbation of COPD (AECOPD). Method A monocentric non-randomized parallel cluster design was applied. The primary endpoint was the difference between Chronic Respiratory Questionnaire (CRQ) Mastery Scores at hospital discharge and 13 weeks post-discharge. Secondary endpoints were differences between other CRQ scores, numbers of rehospitalisations and self-reported exacerbations. The study would end either 13 weeks after the full sample size was achieved or when study time ran out. Results The study was terminated before reaching the targeted sample size. Of 174 invitees, 69 (39.7%, 30 control, 39 intervention) consented to participate. Of those, 47 completed the study, 45 of whom had complete data sets for the primary endpoint. No differences in QoL scores, unplanned COPD-related rehospitalisations or unplanned all-cause rehospitalisations were detected. The mean number of self-reported moderate exacerbations was higher in the intervention group ( p = 0.006). Conclusion The pilot study had slow recruitment, high drop-out rates, and no significant effect on 3-month outcomes. Further research should focus on enhancing the current understanding of how to motivate and recruit patients in this setting. ClinicalTrials.gov ID NCT 04011332.

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Decreasing Hospital Readmissions Utilizing an Evidence-Based COPD Care Bundle

Cited by 3 publications

References 16 publications

Association of Blood Inflammatory Biomarkers with Clinical Outcomes in Patients with AECOPD: An 8-Year Retrospective Study in Beijing

Association of Blood Inflammatory Biomarkers with Clinical Outcomes in Patients with AECOPD: An 8-Year Retrospective Study in Beijing

LUNG Year in Review: 2022

Effect of a nurse-led integrated care intervention on quality of life and rehospitalisation in patients with severe exacerbation of COPD—a pilot study

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