title: C-Reactive Protein at Discharge, Diabetes Mellitus and ≥ 1 Hospitalization During Previous Year Predict Early Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.
abstract: Recurrent hospitalizations in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients have clinical and economic consequences; particularly those readmitted soon after discharge. The aim of our observational study was to determine predictors of early readmission to hospital (30 days from discharge). Prospective data on 125 hospitalized AECOPD patients were collected over a 30-month period at two Spanish university hospitals. Based on readmission after discharge, patients were divided into non-readmitted (n = 96) and readmitted (n = 29). Measures of serum inflammatory biomarkers were recorded on admission to hospital, at day 3 and at discharge; data on clinical, laboratory, microbiological and severity features were also recorded. In a multivariate model, C-reactive protein (CRP) at discharge ≥ 7.6 mg/L, presence of diabetes and ≥ 1 hospitalization for AECOPD during previous year were significant risk factors for predicting readmission. Presence of all 3 risk factors perfectly identified the readmitted patients (positive and negative predictive values of 1.000; 95% CI, 1.00-1.00). A combination of 3 readily available clinical and biochemical parameters is accurate in identifying hospitalized AECOPD patients at risk for early readmission.
authors.affiliation: 1 Cardio-Thoracic Department, Pneumology and Respiratory Intensive Care Unit, "Carlo Poma" Hospital , Mantova , Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Crisafulli
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
authors.forename: Arturo
authors.initials: A
authors.lastname: Huerta
authors.forename: Raúl
authors.initials: R
authors.lastname: Méndez
authors.forename: Mónica
authors.initials: M
authors.lastname: Guerrero
authors.forename: Raquel
authors.initials: R
authors.lastname: Martinez
authors.forename: Adamantia
authors.initials: A
authors.lastname: Liapikou
authors.forename: Néstor
authors.initials: N
authors.lastname: Soler
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sethi
authors.forename: Rosario
authors.initials: R
authors.lastname: Menéndez
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010359:Patient Readmission; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein
keywords: acute exacerbation; chronic obstructive pulmonary disease; inflammatory response; predictors; readmission