Factors Related to Chronic Obstructive Pulmonary Disease Readmission in Taiwan

Abstract

This study examines the relationships among physiological, psychological, and social factors and hospital readmission to develop a model predicting chronic obstructive pulmonary disease (COPD) readmission for 145 patients with COPD following hospital discharge at 14 days and 90 days in Taiwan. Daily functioning, comorbidity, severity of illness, self-efficacy, depressive symptoms, and perceived informal support were regressed on hospital readmission. Daily functioning was the only significant variable to predict COPD readmission at 90 days in the Taiwan population living in a rural area. Age was significantly correlated with 14 days readmission. Post hoc analyses examined differences in three ethnic groups. Mainlanders perceived less family support, had higher depressive symptoms and lower daily functioning than the majority culture Fukiens and Hakkas, or the Aborigines. The study reinforced the need for identification of cultural differences and low functioning as risk factors for early readmission so they can be addressed in discharge planning.

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

“…Nine studies examining the prospective associations between clinical levels and symptoms of psychological distress and exacerbation risk for patients with COPD [9,10,[23][24][25][26][27][28][29] were recently evaluated in a review paper [8]. Three of those studies evaluated outpatients [23][24][25], whereas one included a cohort of elderly medical patients including non-COPD patients [29].…”

An official European Respiratory Society statement on physical activity in COPD

“…To date, seven prospective longitudinal studies have assessed the association between levels of regular physical activity and hospital admission or readmission due to COPD exacerbations [30,113,[141][142][143][144][145]. All studies consistently showed a statistically significant association of low physical activity levels with increased risk of hospitalisations.…”

“…Although all studies reported associations adjusted for confounders, just one study adjusted for previous COPD hospitalisations, which is one of the most important risk factors for readmission [146]. Importantly, the studies have shown that the amount of regular physical activity needed to obtain a significant effect on admissions due to COPD is relatively small, equivalent to walking or cycling for 2 h per week [30,113,[141][142][143][144][145].…”

Evaluation of physical activity in patients with chronic obstructive pulmonary disease: recommendations of European Respiratory Society

“…На сегодняшний день взаимосвязь между уровнем регулярной ФА и частотой госпитализаций при обострениях ХОБЛ изучалось в 7 проспективных продольных исследованиях [30,113,[141][142][143][144][145] и во всех показана стабильная достоверная взаимосвязь низкой ФА с повышением риска госпитализаций. Несмотря на то, что результаты скорректированы по сопутствующим факторам, только в 1 исследовании корректировка производилась еще и по частоте предшествующих направлений в стационар по пово ду ХОБЛ, которые являются важнейшим фактором повторных госпитализаций [146].…”

“…Несмотря на то, что результаты скорректированы по сопутствующим факторам, только в 1 исследовании корректировка производилась еще и по частоте предшествующих направлений в стационар по пово ду ХОБЛ, которые являются важнейшим фактором повторных госпитализаций [146]. Продемонстриро вано, что объем регулярной ФА, необходимый для получения доказательств достоверного влияния на частоту госпитализаций у пациентов с ХОБЛ, доста точно невелик и эквивалентен ходьбе пешком или езде на велосипеде в течение 2 ч в неделю [30,113,[141][142][143][144][145].…”