Readmissions for COPD: propensity case-matched comparison between pulmonary and non-pulmonary departments.
BACKGROUND
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common cause of hospitalisation, and the readmission rate is high. We aimed to determine whether patients discharged from a pulmonary department (PD) after an AECOPD episode had a lower COPD-related readmission rate during the next 12 months than comparable patients discharged from other internal medicine departments (ODs).


METHODS
The medical records of 566 patients discharged after an episode of AECOPD between March 2006 and December 2008 at Oslo University Hospital, Aker, were reviewed retrospectively. Demographic and medical data, together with number of readmissions because of AECOPD during 12 months following the index admission were extracted. We matched patients discharged from the PD and the ODs using a propensity score and used the paired t-test to compare COPD-related readmission rates between the matched patients.


RESULTS
In total, 481 patients were included in the analysis, 247 patients discharged from the PD and 234 from ODs. The propensity score matching process resulted in 155 well-matched pairs. The mean (standard deviation) number of readmissions within 1 year was 0.8 (1.3) for the PD versus 1.1 (1.9) for ODs (P = 0.09). After adjusting for exposure time, the corresponding readmission rates were 1.1 (2.3) and 1.6 (4.0) per year, respectively (P = 0.17).


CONCLUSIONS
There was little difference in COPD-related readmission rates between comparable patients discharged from the PD and the ODs after an AECOPD during 1 year following the index admission.
HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway.
Ying
Y
Wang
Knut
K
Stavem
Sjur
S
Humerfelt
Fredrik A
FA
Dahl
Torbjørn
T
Haugen
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000628:therapy*; D015272:Pulmonary Medicine / Q000706:statistics & numerical data*; D012189:Retrospective Studies
COPD; exacerbation; propensity score; readmission