Garcia-Aymerich et al identified risk factors for readmission for exacerbation in a patient with COPD. The risk of readmission increases with the severity of the disease. The authors are from Spain participating in the EFRAM study (Estudi dels Factors de Risk d'Aguditzacio de la MPOC).
Patient selection: COPD
Risk factors for readmission from multivariate analysis:
(1) >= 3 COPD admissions in the past year (hazard ratio 1.66)
(2) percent predicted FEV1 (hazard ratio 0.97; risk associated with lower percent)
(3) PaO2 in kPa (hazard ratio 0.88; risk associated with hypoxemia)
(4) controlled by a pulmonologist (hazard ratio 1.66 vs general practitioner)
(5) therapy with anticholinergics (hazard ratio 1.81)
(6) usual daily physical activity (see below)
Usual Daily Physical Activity
Adjusted Hazard Ratio
> 232 kcal/day
0.54
79-232 kcal/day
0.87
< 79 kcal per day
1.00
where:
• A pulmonologist might be expected to care for more challenging patients.
These findings suggest that improving daily physical activity may reduce the risk of readmission for an exacerbation.
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