title: Home intervention and predictor variables for rehospitalization in chronic obstructive pulmonary disease exacerbations.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) exacerbation increases mortality and resources used associated with hospitalization. We studied whether early home monitoring reduces the rate of readmission and if there are any predictor variables.
  
  
  METHODS
  We performed a prospective, controlled, parallel-group study in patients who were hospitalized for COPD. Patients whose residence was within less than 15km from the hospital were assigned to an interventional group (home visits by nurses about 48-72hours after discharge), the remainder were assigned to a conventional care group. The rate of rehospitalization within the first month was compared between the two groups, as well as those variables that showed a predictive capability.
  
  
  RESULTS
  Seventy one patients were included: 35 in the conventional care group and 36 in the interventional group. In the latter, the treatment was modified in 13 patients (36%). The hospital readmission rate was 17%, which was similar in both groups (P=.50). For every 5-year increase in age, the risk for readmission was 2.54 (95%CI, 1.06-5.07) and for each increase of 10mmHg in PaCO(2), the risk of readmission was 8.34 (95%CI, 2.43-18.55).
  
  
  CONCLUSIONS
  Early home monitoring did not decrease the readmission rate during the first month. Older age and high PaCO(2) are factors that identify the group with a high risk for rehospitalization.
authors.affiliation: Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, España. bjg01co@hotmail.com
authors.forename: Bernabé
authors.initials: B
authors.lastname: Jurado Gámez
authors.forename: Nuria
authors.initials: N
authors.lastname: Feu Collado
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Jurado García
authors.forename: Francisco
authors.initials: F
authors.lastname: García Gíl
authors.forename: Elisa
authors.initials: E
authors.lastname: Muñoz Gomariz
authors.forename: Luís
authors.initials: L
authors.lastname: Jiménez Murillo
authors.forename: Luís
authors.initials: L
authors.lastname: Muñoz Cabrera
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000097:blood; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006792:House Calls; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D010313:Partial Pressure; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000451:nursing*; D015272:Pulmonary Medicine; D013030:Spain / Q000453:epidemiology; D013689:Telephone
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D002245:Carbon Dioxide