The Factors Associated with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Patient within 28 Days: Yasothon Hospital
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Abstract
Background: Chronic obstructive pulmonary disease (COPD) is one of the causes of illness and death of the population in Thailand, COPD patients who have severe exacerbations even though they have been admitted. After being hospitalized, some patients had symptoms relapse and had to be readmitted to the hospital in a short period of time, which was extremely detrimental to the patients.
Objective: To study the factors associated with acute exacerbations of COPD in patients who were readmitted to the hospital within 28 days at Yasothon Hospital.
Study Designs: Retrospective analytical study. Data was collected retrospectively from medical records of inpatients in the Department of Medicine at Yasothon Hospital. The study included demographic data, treatment outcomes, and clinical factors of COPD patients with acute exacerbations. The data was collected to identify the factors that led to the exacerbation and readmission within 28 days, from October 1, 2022 to September 30, 2023. The data was analyzed using statistical methods. Descriptive statistics were used to describe the demographic data of the patients, including percentage, frequency, mean, and standard deviation. Chi-square test was used to compare the clinical factors of the patients who were readmitted to the hospital. P-value of less than 0.05 was considered statistically significant.
Results: A total of 97 COPD patients with acute exacerbation were readmitted to the hospital within 28 days during the study period. The mean age of the patients was 72.75 years, and the majority were male (82 patients, 84.54%). Factors associated with readmission: Having more than 3 co-morbidities (OR=1.57, p < 0.001) Disease severity (OR=2.72, p < 0.001). Trigger factors for acute exacerbation: Pneumonia: 32.99% in the first admission and 48.45% in readmission. (p=0.044) The most common pathogens; First admission is Klebsiella pneumoniae (28.87%) and readmission is Acinetobacter baumannii. (23.71%, p=0.037) The average duration of symptoms before admission; First admission is 2.5 days, readmission is 1.5 days. (p=0.001) The average length of stay; First admission is 5 days, readmission is 8.2 days. (p=0.261)
Conclusion: The factors associated with readmission within 28 days in COPD patients with acute exacerbation were having more than 3 co-morbidities and disease severity. The main trigger factor for acute exacerbation was pneumonia.
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