Risk factors for another hospitalization in COPD patients hospitalized for exacerbation

Abstract

Introduction: COPD exacerbation is a potentially life threatening event in the course of COPD. Each episode should be as strongly avoided as possible.

Aim: To determine the severity criteria of a COPD exacerbation that are predictive of another readmission.

Materials and methods: Retrospective study of 151 patients admitted in our department for COPD exacerbation. Two groups were identified: G1: patients rehospitalized for COPD exacerbation, G2: patients not rehospitalized for COPD exacerbation.

Results: G1: 73 patients (48%) and G2: 78 patients (52%). Male patients represented 145 (96%) of all patients. G1 patients were younger than G2 (63 years vs 67 years; p=0.017). Associated cardio-vascular diseases, diabetes mellitus and tobacco smoking didn't differ from G1 to G2 (27.4% vs 19.2% ; p=0.2, 22% vs 17% ; p=0.4 and 62 pack- year vs 58 pack- year respectively ; p=0.53). G1 patients had less frequently polypnea compared to G2 (83.5% vs 91% ; p=0.001). Consciousness alteration was more frequently noticed in G1 as compared to G2 (23.2% vs 11.5% ; p=0.05). Nevertheless: neither orthopnea nor tachycardia nor lower limb oedema nor hypoxemia nor hypercapnia nor acidosis were associated in an increased risk of another hospitalisation for COPD exacerbation between G1 and G2 (11% vs 9.5% ; p=0,6) , (26% vs 33% ; p=0.13) , (6.8% vs 7.6% ; p=0.9), (48% vs 46% ; p=0.5) , (52% vs 51% ; p=0.7), ( 28.7% vs 37% ; p=0.3) respectively. Moreover the fact that a patient was readmitted in intensive care unit for the first COPD exacerbation wasn't a risk factor for his admission in hospital another time for COPD exacerbation (22% vs 11.7% ; p=0.09).