[Risk factors of readmission in acute exacerbation of moderate-to-severe chronic obstructive pulmonary disease].
OBJECTIVE
More effective management of chronic obstructive pulmonary disease (COPD) and improved survival of COPD patients requires a better understanding of the risk factors for exacerbation. The aim of this study was to identify factors related to readmission in patients with moderate-to-severe COPD.


METHODS
Ninety patients with moderate-to-severe COPD hospitalized consecutively for acute exacerbation were studied prospectively. At discharge, the following potential predictors were assessed: clinical and spirometric variables, arterial blood gases, and respiratory muscle strength determined noninvasively. The patients were followed for a period of 3 months. Readmission for exacerbation and time intervals free of hospitalization were recorded.


RESULTS
Univariate analysis showed that the presence of cor pulmonale (P<.05), long-term oxygen therapy (P<.05), hypercapnia (P<.05), and high inspiratory load--mean inspiratory airway pressure measured at the mouth exceeding 0.40 cm H2O and a pressure-time index greater than 0.25 (P<.05 for both variables)--increased the risk of hospitalization for exacerbation. Multivariate analysis showed that only cor pulmonale (P<.05) and a high pressure-time index (>0.25, P<.05) were independently related to risk of readmission.


CONCLUSIONS
Cor pulmonale and a high pressure-time index are independent risk factors for hospitalization for exacerbation of moderate-to-severe COPD.
González
C
C
Servicio de Neumología, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain. cruz.gonzalez@uv.es
Servera
E
E
Ferris
G
G
Blasco
M L
ML
Marín
J
J
D000208:Acute Disease; D000368:Aged; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000534:rehabilitation* / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index
D010100:Oxygen