All-cause readmission rate and risk factors of 30- and 90-day after discharge in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
All-cause readmission rate and risk factors of 30- and 90-day after discharge in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
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DOI：
10.1177/17534666231202742
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发表时间：
2023-01
影响因子：
4.3
通讯作者：
Li, Jiansheng
中科院分区：
文献类型：
--
作者：
Ruan, Huanrong;Zhao, Hulei;Wang, Jiajia;Zhang, Hailong;Li, Jiansheng
关键词：
慢性阻塞性肺疾病（COPD）住院后的再入院率高得惊人，频繁的再入院意味着更高的死亡风险和沉重的经济负担。然而，COPD患者全因再入院的信息有限。本研究旨在系统总结出院后30天和90天内全因COPD再入院率及其潜在风险因素。检索了8个电子数据库，以识别从开始到2022年8月1日关于COPD再入院的相关观察性研究。采用Newcastle-Ottawa量表进行方法学质量评价。我们采用随机效应模型或固定效应模型来估计合并的全因COPD再入院率和潜在的危险因素。共纳入28项研究，其中27项和8项研究分别总结了30天和90天的全因再入院。30天和90天内合并的全因COPD再入院率分别为18%和31%。世界卫生组织区域最初被认为是异质性的来源。我们确定了饮酒、出院目的地、前一年两次或多次住院以及合并症（如心力衰竭、糖尿病、慢性肾病、贫血、癌症或肿瘤）为全因再入院的潜在风险因素，而女性和肥胖为保护因素。COPD患者的全因再入院率较高，我们还确定了一些潜在的风险因素。因此，迫切需要加强早期随访和针对性干预，调整或避免出院后的危险因素，以减轻频繁再入院带来的重大卫生经济负担。该系统性综述和荟萃分析方案在PROSPERO进行了前瞻性注册（编号CRD 42022369894）。
The readmission rate following hospitalization for chronic obstructive pulmonary disease (COPD) is surprisingly high, and frequent readmissions represent a higher risk of mortality and a heavy economic burden. However, information on all-cause readmissions in patients with COPD is limited. This study aimed to systematically summarize all-cause COPD readmission rates within 30 and 90 days after discharge and their underlying risk factors. Eight electronic databases were searched to identify relevant observational studies about COPD readmission from inception to 1 August 2022. Newcastle-Ottawa Scale was used for methodological quality assessment. We adopt a random effects model or a fixed effects model to estimate pooled all-cause COPD readmission rates and potential risk factors. A total of 28 studies were included, of which 27 and 8 studies summarized 30- and 90-day all-cause readmissions, respectively. The pooled all-cause COPD readmission rates within 30 and 90 days were 18% and 31%, respectively. The World Health Organization region was initially considered to be the source of heterogeneity. We identified alcohol use, discharge destination, two or more hospitalizations in the previous year, and comorbidities such as heart failure, diabetes, chronic kidney disease, anemia, cancer, or tumor as potential risk factors for all-cause readmission, whereas female and obesity were protective factors. Patients with COPD had a high all-cause readmission rate, and we also identified some potential risk factors. Therefore, it is urgent to strengthen early follow-up and targeted interventions, and adjust or avoid risk factors after discharge, so as to reduce the major health economic burden caused by frequent readmissions. This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (no. CRD42022369894).
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DOI：
10.2147/copd.s52557
发表时间：
2013
影响因子：
2.8
作者：
Bollu V;Ernst FR;Karafilidis J;Rajagopalan K;Robinson SB;Braman SS
通讯作者：
Braman SS
影响因子：
5.7
作者：
Buhr, Russell G.;Jackson, Nicholas J.;Ong, Michael K.
通讯作者：
Ong, Michael K.
影响因子：
8.3
作者：
Iyer, Anand S.;Bhatt, Surya P.;Dransfield, Mark T.
通讯作者：
Dransfield, Mark T.
影响因子：
3.1
作者：
Goto, Tadahiro;Yoshida, Kazuki;Hasegawa, Kohei
通讯作者：
Hasegawa, Kohei
影响因子：
--
作者：
Candrilli, Sean D;Dhamane, Amol D;Kaila, Shuchita
通讯作者：
Kaila, Shuchita