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Readmissions for COPD: propensity case-matched comparison between pulmonary and non-pulmonary departments

Authors

  • Ying Wang,

    Corresponding author
    1. HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
    2. Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
    • Correspondence

      Ying Wang, MD, HØKH, Research Centre, Akershus University Hospital, P. O. Box 95, N-1478 Lørenskog, Norway.

      Tel: + 47 679 68 708, + 47 996 25 607 (mobile phone)

      Fax: + 47 67 98 99 00

      email: ying.wang@ahus.no

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  • Knut Stavem,

    1. HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
    2. Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
    3. Faculty of Medicine, University of Oslo, Lørenskog, Norway
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  • Sjur Humerfelt,

    1. Clinic for Allergy and Airway Diseases, Oslo, Norway
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  • Fredrik A. Dahl,

    1. HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
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  • Torbjørn Haugen

    1. HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
    2. Clinic for Allergy and Airway Diseases, Oslo, Norway
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  • Authorship and contributorship

    YW (e-mail: ying.wang@ahus.no): contributed to study design, and is main responsible for data collection, analyses and interpretation of data, drafting of the manuscript and final approval of the manuscript.

    KS (e-mail: knut.stavem@medisin.uio.no): contributed to study design, analyses and interpretation of data, draft and revision of the article and approved the final manuscript.

    SH (e-mail: sjur@kal.nhn.no): contributed to study design, data collection, revision of the article and approved the final manuscript. FD (e-mail: fredrik.dahl@ahus.no): contributed to study design, reviewed analyses and interpretation of data, and approved the final manuscript.

    TH (e-mail: torbjorn.haugen@ahus.no): contributed to study design, drafting of the manuscript, revision of the article and approved the final manuscript.

  • Ethics

    The study was accepted by the local Privacy Ombudsman for Clinical Research at Oslo University Hospital, Norway.

  • Conflicts of interest

    The authors have stated explicitly that there are no conflicts of interest in connection with this article.

  • Funding

    This study was supported by Grant 2779038 the South-Eastern Norway Regional Health Authority and Grant 2779010 from the Research Council of Norway

Abstract

Introduction

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common cause of hospitalisation, and the readmission rate is high. We aimed to determine whether patients discharged from a pulmonary department (PD) after an AECOPD episode had a lower COPD-related readmission rate during the next 12 months than comparable patients discharged from other internal medicine departments (ODs).

Methods

The medical records of 566 patients discharged after an episode of AECOPD between March 2006 and December 2008 at Oslo University Hospital, Aker, were reviewed retrospectively. Demographic and medical data, together with number of readmissions because of AECOPD during 12 months following the index admission were extracted. We matched patients discharged from the PD and the ODs using a propensity score and used the paired t-test to compare COPD-related readmission rates between the matched patients.

Results

In total, 481 patients were included in the analysis, 247 patients discharged from the PD and 234 from ODs. The propensity score matching process resulted in 155 well-matched pairs. The mean (standard deviation) number of readmissions within 1 year was 0.8 (1.3) for the PD versus 1.1 (1.9) for ODs (P = 0.09). After adjusting for exposure time, the corresponding readmission rates were 1.1 (2.3) and 1.6 (4.0) per year, respectively (P = 0.17).

Conclusion

There was little difference in COPD-related readmission rates between comparable patients discharged from the PD and the ODs after an AECOPD during 1 year following the index admission.

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