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Risk factors and associated outcomes of hospital readmission in COPD: a systematic review

journal contribution
posted on 2023-05-20, 16:52 authored by Njoku, CM, Alqahtani, JS, Barbara Wimmer, Gregory PetersonGregory Peterson, Kinsman, L, Hurst, JR, Bonnie BereznickiBonnie Bereznicki

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of unplanned readmission. There is need to identify risk factors for, and strategies to prevent readmission in patients with COPD.

Aim: To systematically review and summarise the prevalence, risk factors and outcomes associated with rehospitalisation due to COPD exacerbation.

Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Five databases were searched for relevant studies.

Results: Fifty-seven studies from 30 countries met the inclusion criteria. The prevalence of COPD-related readmission varied from 2.6 to 82.2% at 30 days, 11.8–44.8% at 31–90 days, 17.9–63.0% at 6 months, and 25.0–87.0% at 12 months post-discharge. There were differences in the reported factors associated with readmissions, which may reflect variations in the local context, such as the availability of community-based services to care for exacerbations of COPD. Hospitalisation in the previous year prior to index admission was the key predictor of COPD-related readmission. Comorbidities (in particular asthma), living in a deprived area and living in or discharge to a nursing home were also associated with readmission. Relative to those without readmissions, readmitted patients had higher in-hospital mortality rates, shorter long-term survival, poorer quality of life, longer hospital stay, increased recurrence of subsequent readmissions, and accounted for greater healthcare costs.

Conclusions: in the previous year was the principal risk factor for COPD-related readmissions. Variation in the prevalence and the reported factors associated with COPD-related readmission indicate that risk factors cannot be generalised, and interventions should be tailored to the local healthcare environment.


Publication title

Respiratory Medicine



Article number







School of Pharmacy and Pharmacology


W B Saunders Co Ltd

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32 Jamestown Rd, London, England, Nw1 7By

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© 2020 Elsevier Ltd.

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Clinical health not elsewhere classified

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