title: Risk factors for hospital readmission for COPD after implementation of the GOLD guidelines.
abstract: BACKGROUND
  Few updated studies have investigated risk factors for readmission for chronic obstructive pulmonary disease (COPD) since the implementation of the latest treatment guidelines.
  
  
  OBJECTIVE
  To evaluate a series of potential risk factors for readmission in patients with COPD and in a subgroup with very frequent readmissions after implementation of the Global Initiative for Chronic Obstructive Lung Disease guidelines.
  
  
  METHODS
  Two hundred and fifty patients admitted for acute exacerbation of COPD (AECOPD) were recruited over 1 year. The readmission frequency in the ensuing year following hospital discharge was recorded and analysed against potential risk factors collected during the index admission.
  
  
  RESULTS
  In the ensuing year, 183 (73.2%) patients were readmitted at least once for AECOPD. Previous non-invasive ventilation for AECOPD (HR 1.56, 95%CI 1.08-2.26), COPD Assessment Test score (HR 1.03, 95%CI 1.00-1.05), 6-minute walk distance (HR 0.98 per 10 m increase, 95%CI 0.97-0.99) and number of admissions for AECOPD in the previous year (HR 1.11, 95%CI 1.06-1.16) were independently associated with time to first readmission. Subgroup analysis showed that anxiety (OR 3.97, 95%CI 1.49-10.57) was strongly associated with very frequent readmissions (⩾4 in 1 year).
  
  
  CONCLUSIONS
  AECOPD is associated with high rates of readmission. Anxiety is a potential modifiable factor associated with very frequent readmissions.
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: M S N
authors.initials: MS
authors.lastname: Tsui
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: F C T
authors.initials: FC
authors.lastname: Lun
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: L S L
authors.initials: LS
authors.lastname: Cheng
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: A P S
authors.initials: AP
authors.lastname: Cheung
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: V L
authors.initials: VL
authors.lastname: Chan
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: W-S
authors.initials: WS
authors.lastname: Leung
authors.affiliation: Division of Respiratory Medicine, Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region, China.
authors.forename: C-M
authors.initials: CM
authors.lastname: Chu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy*; D012307:Risk Factors