Characteristics of frail patients with acute exacerbations of COPD who experience readmissions

Osadnik, Christian; Kavanagh, Alethea; MacDonald, Martin; Tran, Anne; Haines, Terry; Bardin, Philip G.

doi:10.1183/13993003.congress-2019.oa3813

Cited by 3 publications

(3 citation statements)

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“…It increases the risk of acute exacerbations of COPD (AECOPD) [50,74,[80][81][82][83] and may relate to higher levels of C-reactive protein, which is, in turn, associated with increased exacerbations, poorer lung function and mortality [84,85]. Moreover, COPD exacerbations in people with frailty carry an increased (6.3-fold) risk of requiring mechanical ventilation compared to people without frailty [81], and the presence of frailty during COPD exacerbations has been suggested to associate with increased risk of readmission and/or mortality [86].…”

Section: Copdmentioning

confidence: 99%

European Respiratory Society statement on frailty in adults with chronic lung disease

et al. 2023

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Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine, however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a pre-requisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work.This European Respiratory Society Statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies), and identification of evidence gaps to inform future priority areas of research. Frailty is under-represented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.

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Section: Copdmentioning

confidence: 99%

European Respiratory Society statement on frailty in adults with chronic lung disease

et al. 2023

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“…Comorbidities, previous exacerbations and hospitalizations, and the initial length of hospital stay were found to be the most important factors affecting rehospitalization. The presence of frailty during a COPD exacerbation was associated with readmission and/or mortality [ 91 ]. In addition, rehospitalization for COPD was found to be associated with mortality in older adults [ 92 ].…”

Section: Predictive and Preventive Strategiesmentioning

confidence: 99%

Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review

Bag Soytas,

Levinoff,

Smith

et al. 2023

Epidemiologia

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Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults.

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“…work of breathing, impaired gas exchange and comorbidities) to decide on patients' hospital admission or discharge. OSADNIK et al [38] evaluated frailty as a prognostic factor for 90-day readmission in patients hospitalised for an acute exacerbation of COPD. Frailty was associated with a 4.5-fold risk of readmission; and those readmitted took longer to perform the five-repetition STS test at the first admission, and improved less in the five-repetition STS test, 6MWT and quadriceps muscle strength from first admission to 1 month post-discharge.…”

Section: Take-home Messagesmentioning

confidence: 99%

ERS International Congress, Madrid, 2019: highlights from the Allied Respiratory Professionals' Assembly

et al. 2020

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This article provides an overview of outstanding sessions that were (co)organised by the Allied Respiratory Professionals' Assembly during the European Respiratory Society International Congress 2019 in Madrid, Spain. Session content was mainly targeted at allied respiratory professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses, and is summarised in this document. Short take-home messages related to pulmonary function testing highlight the importance of quality control. Furthermore, novel findings regarding the assessment of functional status call attention to bodily factors that can affect functional status. Regarding pulmonary rehabilitation, data were presented about the use of equipment and type of exercise training in COPD and lung cancer. Recent developments in physical activity-related research give insight in enablers of physical activity after hospital admission. The importance of integrated respiratory care was also highlighted, with the occupational therapist, nurse, and nutritional and psychological counsellor playing a pivotal role, which relates directly to research in the field of respiratory nursing that formulates the need for more nursing led-interventions in the future. To conclude, this review provides readers with valuable insight into some of the emerging and future areas affecting clinical practice of allied healthcare professionals.

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Characteristics of frail patients with acute exacerbations of COPD who experience readmissions

Cited by 3 publications

References 0 publications

European Respiratory Society statement on frailty in adults with chronic lung disease

European Respiratory Society statement on frailty in adults with chronic lung disease

Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review

ERS International Congress, Madrid, 2019: highlights from the Allied Respiratory Professionals' Assembly

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