Alqahtani et al identified predictors for COPD exacerbation with hospital readmission. These can help to identify a patient who may benefit from more aggressive management. The authors are from University College London, Prince Sultan Military College of Health Sciences, King Faisal University, Jazan University and Royal Free Hospital London.
Patient selection: patient being discharged following admission for COPD exacerbation
Outcome: 90-day readmission
Predictors at discharge:
(1) higher frailty score (OR 1.2) using the Reported Edmonton Frail Scale (REFS)
(2) lower peak inspiratory flow rate in liters per minute (PIFR, OR 0.95)
(3) higher COPD Assessment Test (CAT) score at discharge (OR 1.05)
(4) number of exacerbations in the past 12 months (OR 1.4)
Based on data shown for 30-day readmission, the following cutoffs will be used in the implementation:
(1) frailty score: >=11
(2) PIFR: < 60 L/min (< 77.5 had highest Youden in Table 6)
(3) CAT score: >=32
(4) exacerbations: >= 3
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