title: Predictors of hospital admission two months after emergency department evaluation of COPD exacerbation.
abstract: BACKGROUND
  Limited information is available regarding the factors related to short-term hospital admission following an exacerbation of chronic obstructive pulmonary disease (eCOPD).
  
  
  OBJECTIVE
  The aim of this study was to identify variables related to short-term admission in patients with an eCOPD.
  
  
  METHODS
  This was a prospective cohort study of patients with an eCOPD who attended an emergency department (ED) at 1 of 16 hospitals. Information on possible predictor variables was recorded during the ED stay, 24 h after admission to the hospital or after ED discharge home, and at hospital discharge or 1 week later if discharged home from the ED. An admission after an eCOPD within 2 months was the outcome of interest. Multivariate models were employed for patients admitted to the hospital or discharged home from the ED.
  
  
  RESULTS
  For patients discharged home from the ED, eCOPD-related hospital admissions in the previous year [odds ratio (OR) 1.98 and 2.33], pCO2 at ED admission (ORs 2.02 and 2.90), the number of ED visits within 1 week of the index ED visit (OR 5.14) and dyspnea level 1 week after the index ED visit (ORs 2.66 and 1.40) were predictors of short-term admission [area under the curve (AUC) 0.82]. For patients admitted to the hospital during the index ED visit, baseline FEV1% (ORs 1.32 and 1.88), eCOPD-related hospital admissions in the previous year (ORs 1.28 and 2.51), severe baseline dyspnea (OR 2.57) and dyspnea level 1 week after the index ED visit (ORs 2.15 and 1.74) were predictors of short-term readmission (AUC 0.73).
  
  
  CONCLUSIONS
  Just a few easily recorded parameters may allow clinicians to identify patients at a higher risk of short-term readmission and establish preventive strategies.
authors.affiliation: Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Quintana
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Esteban
authors.forename: Susana
authors.initials: S
authors.lastname: Garcia-Gutierrez
authors.forename: Urko
authors.initials: U
authors.lastname: Aguirre
authors.forename: Nerea
authors.initials: N
authors.lastname: Gonzalez
authors.forename: Iratxe
authors.initials: I
authors.lastname: Lafuente
authors.forename: Marisa
authors.initials: M
authors.lastname: Bare
authors.forename: Nerea
authors.initials: N
authors.lastname: Fernandez de Larrea
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivas-Ruiz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors