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

Abstract

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), SouthWest Ethiopia. Sociodemographic, 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.

Factors affecting the length of stay and hospital readmission rates after an acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…None of the selected articles described the risk of bias for random sequence generation, allocation concealment, blinding of participants and researchers, or blinding of outcome assessment, so the above biases were all considered low-risk. Two articles had a high risk of bias from incomplete result data (14,17), and 5 articles had a low risk of bias from incomplete result data (12,13,15,16,18). Selective reporting domains and other biases for all articles were low-risk (Figure 7).…”

Mechanisms of COPD Exacerbation Recurrence

“…Since the publication of our systematic review, we have updated our search and identified six additional studies (418)(419)(420)(421)(422)(423). Generally, all the reported risk factors found in these additional studies were identified in our previous systematic review.…”

“…Generally, all the reported risk factors found in these additional studies were identified in our previous systematic review. Anbesse et al conducted a prospective study and found that frequent admissions and the use of long-term oxygen to be associated with 30-day readmission (418). Similarly, another prospective study reported limitation in performing basic activities of daily living and frequent admissions for COPD exacerbations to be associated with risk of readmission at 30 and 90 days (419).…”

Impact of lean six sigma at pharmacy unit on hospital profitability before and during Covid-19 pandemic

“…If the target is directed more at the pharmaceutical management, the effect on LOS will be indirect. The efficiency of the pharmaceutical department can affect LOS by ensuring drug certainty and quality (Galli et al, 2016), ensuring drug availability (Tefera et al, 2020), ensuring drug adherence (Monfort et al, 2016), preventing drug poisoning (Chelkeba et al, 2018) and providing assistance in the patient care (Anbesse et al, 2020).…”