Analysis of risk factors for re-hospitalization in patients with acute exacerba⁃tion of chronic obstructive pulmonary disease within one year

YANG Liqing; GAO Lingyun; YANG Lingjing; LU Qi; XU Qing

doi:10.3969/j.issn.2096-3351.2022.05.008

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Analysis of risk factors for re-hospitalization in patients with acute exacerba⁃tion of chronic obstructive pulmonary disease within one year

更新时间：2023-05-05

- Analysis of risk factors for re-hospitalization in patients with acute exacerba⁃tion of chronic obstructive pulmonary disease within one year
- Journal of Southwest Medical University Vol. 45, Issue 5, Pages: 404-408(2022)
- 作者机构：
  
  四川省医学科学院·四川省人民医院呼吸与危重症医学科,成都,610100
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2096-3351.2022.05.008
  CLC：
- Published：2022，
  
  Published Online：20 September 2022，
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YANG Liqing, GAO Lingyun, YANG Lingjing, et al. Analysis of risk factors for re-hospitalization in patients with acute exacerba⁃tion of chronic obstructive pulmonary disease within one year. [J]. Journal of Southwest Medical University 45(5):404-408(2022)
DOI：

YANG Liqing, GAO Lingyun, YANG Lingjing, et al. Analysis of risk factors for re-hospitalization in patients with acute exacerba⁃tion of chronic obstructive pulmonary disease within one year. [J]. Journal of Southwest Medical University 45(5):404-408(2022) DOI： 10.3969/j.issn.2096-3351.2022.05.008.

摘要

目的探讨慢性阻塞性肺疾病（简称慢阻肺）急性加重病人一年内再入院的危险因素。方法收集本院呼吸与危重症医学科2019年1月至12月期间因慢性阻塞性肺疾病急性加重的住院病人的临床资料，以出院时间为起点，随访1年，以一年内发生急性加重再入院的病人为观察组，未发生急性加重再入院的为对照组，采用单因素分析及logistics回归分析方法，分析慢阻肺急性加重住院病人一年内再入院的危险因素。结果共纳入285例慢阻肺急性加重期住院病人，出院后随访1年，96例（33.68%）一年内再次急性加重入院。两组间男性、吸烟状态、体质量指数低、体质量指数＜18.5kg/m2、伴支气管扩张、胸腔积液、首次住院时血清中性粒细胞计数高、血清降钙素原高、血纤维蛋白原增高，合并呼吸衰竭、肺心病、长期家庭氧疗以及首次住院花费、首次住院天数是慢阻肺病人一年内急性加重再入院的相关危险因素，各相关因素比较差异（P＜0.05）；logistics回归分析发现：体质量指数＜18.5kg/m2、血中性粒细胞计数高，合并肺源性心脏病、首次住院天数长是住院慢性阻塞性肺疾病病人出院后一年内再入院的危险因素，前述各相关因素差异均有统计学意义（P＜0.05）。结论体质量指数＜18.5kg/m2、血中性粒细胞计数高，合并肺源性心脏病、首次住院天数长是慢阻肺病人一年内急性加重再入院的危险因素，临床应采取针对性的防治措施，以改善这类病人的预后。

Abstract

Objective To explore the risk factors for re-hospitalization in patients with chronic obstructive pulmonary disease within one year. Methods The clinical data of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in the Department of Respiratory and Critical Care Medicine of our hospital from January 2019 to December 2019 were collected. The pa⁃tients were followed up for 1 year from the time of discharge. Patients with acute exacerbation readmission within one year were selected as the experimental group，and those without acute exacerbation readmission were selected as the control group. Univariate analysis and logistics regression analysis were used to analyze the risk factors of readmission within one year in hospitalized patients with acute exac⁃erbation of COPD. Results A total of 285 patients with chronic obstructive pulmonary disease were admitted，of which 96 cases （33.68%）were rehospitalized within one year. Between the two groups，male，smoking status，low body mass index，BMI＜18.5 kg/m2， combined with bronchiectasis，pleural fluid，high serum neutrophil count，high serum procalcitonin and high serum fibrinogen at the first hospitalization，combined with respiratory failure and pulmonary heart disease，long-term home oxygen therapy，the cost and days of the first hospitalization were the risk factors of acute exacerbation readmission in COPD patients within one year，with significant dif⁃ferences respectively（P＜0.05）. Logistics regression analysis showed that BMI＜18.5 kg/m2，high count of blood neutrophils，com⁃bined with pulmonary heart disease，long first hospital stay were the risk factors for rehospitalization within one year after discharge in patients with chronic obstructive pulmonary disease，with significant differences respectively（P＜0.05）. Conclusion BMI＜18.5 kg/m2， high count of blood-neutral granulocytes，combined with pulmonary heart disease，long first hospital stay were risk factors for rehospital⁃ization in patients with chronic obstructive pulmonary disease within one year. Targeted prevention and treatment measures could be taken to improve the prognosis of these patients.

关键词

慢性阻塞性肺疾病急性加重再入院危险因素

Keywords

Chronic obstructive pulmonary diseaseAcute exacerbationRe-hospitalizationRisk factors

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