Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia

Beomsu Shin, Sang Ha Kim, Suk Joong Yong, Won Yeon Lee, Sunmin Park, Sang Jun Lee, Seok Jeong Lee, Myoung Kyu Lee

Research output: Contribution to journalArticle

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prognosis of AECOPD patients with or without community-acquired pneumonia (CAP) who hospitalized from January 2012 to December 2015. We investigated mortality and readmission rates within 6 months after the first admission between two groups and analyzed the difference of survival rate according to readmission duration (≤30 vs. >30 days) or intensive care unit (ICU) treatment. Total 308 AECOPD patients (134 with CAP and 174 without CAP) were enrolled. The mean age was 72.3 ± 9.5 years old, and 235 patients (76.3%) were male. The 180-day mortality was higher in AECOPD with CAP than without CAP (24.6% vs. 13.2%; hazard ratio (HR): 1.982; 95% CI: 1.164–3.375; p = 0.012). However, readmission rate showed no significant difference between two groups (51.5% vs. 46.6%; HR: 1.172; 95% CI: 0.850–1.616; p = 0.333). It showed a significantly lower survival rate in AECOPD with CAP rather than without CAP when were readmitted within 30 days (HR: 1.738; 95% CI:1.063–3.017; p = 0.031). According to ICU treatment, survival rate was not significantly different between two groups. Multivariate analysis revealed the readmission within 30 days (p < 0.001), serum hemoglobin concentration (p = 0.010), and albumin level (p = 0.049) were significantly associated with 180-day mortality of AECOPD with CAP. AECOPD with CAP showed lower survival rate than AECOPD without CAP during 6 months. Early readmission within 30 days was significantly associated with an increased risk of mortality.

Original languageEnglish
JournalChronic Respiratory Disease
Volume16
DOIs
Publication statusPublished - 2018 Nov 14

Fingerprint

Chronic Obstructive Pulmonary Disease
Pneumonia
Mortality
Survival Rate
Intensive Care Units
Hospital Mortality
Albumins
Hemoglobins
Hospitalization
Cohort Studies
Multivariate Analysis
Prospective Studies
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Shin, Beomsu ; Kim, Sang Ha ; Yong, Suk Joong ; Lee, Won Yeon ; Park, Sunmin ; Lee, Sang Jun ; Lee, Seok Jeong ; Lee, Myoung Kyu. / Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia. In: Chronic Respiratory Disease. 2018 ; Vol. 16.
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title = "Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia",
abstract = "Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prognosis of AECOPD patients with or without community-acquired pneumonia (CAP) who hospitalized from January 2012 to December 2015. We investigated mortality and readmission rates within 6 months after the first admission between two groups and analyzed the difference of survival rate according to readmission duration (≤30 vs. >30 days) or intensive care unit (ICU) treatment. Total 308 AECOPD patients (134 with CAP and 174 without CAP) were enrolled. The mean age was 72.3 ± 9.5 years old, and 235 patients (76.3{\%}) were male. The 180-day mortality was higher in AECOPD with CAP than without CAP (24.6{\%} vs. 13.2{\%}; hazard ratio (HR): 1.982; 95{\%} CI: 1.164–3.375; p = 0.012). However, readmission rate showed no significant difference between two groups (51.5{\%} vs. 46.6{\%}; HR: 1.172; 95{\%} CI: 0.850–1.616; p = 0.333). It showed a significantly lower survival rate in AECOPD with CAP rather than without CAP when were readmitted within 30 days (HR: 1.738; 95{\%} CI:1.063–3.017; p = 0.031). According to ICU treatment, survival rate was not significantly different between two groups. Multivariate analysis revealed the readmission within 30 days (p < 0.001), serum hemoglobin concentration (p = 0.010), and albumin level (p = 0.049) were significantly associated with 180-day mortality of AECOPD with CAP. AECOPD with CAP showed lower survival rate than AECOPD without CAP during 6 months. Early readmission within 30 days was significantly associated with an increased risk of mortality.",
author = "Beomsu Shin and Kim, {Sang Ha} and Yong, {Suk Joong} and Lee, {Won Yeon} and Sunmin Park and Lee, {Sang Jun} and Lee, {Seok Jeong} and Lee, {Myoung Kyu}",
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Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia. / Shin, Beomsu; Kim, Sang Ha; Yong, Suk Joong; Lee, Won Yeon; Park, Sunmin; Lee, Sang Jun; Lee, Seok Jeong; Lee, Myoung Kyu.

In: Chronic Respiratory Disease, Vol. 16, 14.11.2018.

Research output: Contribution to journalArticle

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T1 - Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia

AU - Shin, Beomsu

AU - Kim, Sang Ha

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AU - Lee, Sang Jun

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AU - Lee, Myoung Kyu

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AB - Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. Pneumonia is a major contributor to hospitalization for AECOPD and has a close relationship with poor outcomes. We performed a prospective cohort study to evaluate the prognosis of AECOPD patients with or without community-acquired pneumonia (CAP) who hospitalized from January 2012 to December 2015. We investigated mortality and readmission rates within 6 months after the first admission between two groups and analyzed the difference of survival rate according to readmission duration (≤30 vs. >30 days) or intensive care unit (ICU) treatment. Total 308 AECOPD patients (134 with CAP and 174 without CAP) were enrolled. The mean age was 72.3 ± 9.5 years old, and 235 patients (76.3%) were male. The 180-day mortality was higher in AECOPD with CAP than without CAP (24.6% vs. 13.2%; hazard ratio (HR): 1.982; 95% CI: 1.164–3.375; p = 0.012). However, readmission rate showed no significant difference between two groups (51.5% vs. 46.6%; HR: 1.172; 95% CI: 0.850–1.616; p = 0.333). It showed a significantly lower survival rate in AECOPD with CAP rather than without CAP when were readmitted within 30 days (HR: 1.738; 95% CI:1.063–3.017; p = 0.031). According to ICU treatment, survival rate was not significantly different between two groups. Multivariate analysis revealed the readmission within 30 days (p < 0.001), serum hemoglobin concentration (p = 0.010), and albumin level (p = 0.049) were significantly associated with 180-day mortality of AECOPD with CAP. AECOPD with CAP showed lower survival rate than AECOPD without CAP during 6 months. Early readmission within 30 days was significantly associated with an increased risk of mortality.

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