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Predicting and preventing hospital readmission for exacerbations of COPD

Chia Wei Kong, Tom M.A. Wilkinson
ERJ Open Research 2020 6: 00325-2019; DOI: 10.1183/23120541.00325-2019
Chia Wei Kong
1Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK
2Clinical and Experimental Sciences, Faculty of Medicine, University Hospital Southampton, Southampton, UK
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  • For correspondence: c.w.kong@soton.ac.uk
Tom M.A. Wilkinson
1Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK
2Clinical and Experimental Sciences, Faculty of Medicine, University Hospital Southampton, Southampton, UK
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Tables

  • TABLE 1

    10 leading reasons for COPD readmissions following index COPD admission [11]

    • COPD

    • Respiratory failure

    • Pneumonia

    • Congestive heart failure

    • Asthma

    • Septicaemia

    • Cardiac dysrhythmias

    • Fluid and electrolyte disorders

    • Intestinal infection

    • Nonspecific chest pain

  • TABLE 2

    Components of various predictive models [68–71]

    ADOBODEXDOSELACE
    • FEV1 % pred

    • mMRC dyspnoea scale

    • Age

    • FEV1 % pred

    • Number of exacerbations per year

    • mMRC dyspnoea scale

    • BMI

    • mMRC dyspnoea scale

    • FEV1 % pred

    • Smoking status

    • Number of exacerbations per year

    • Length of stay

    • Acuity of admission

    • Comorbidities

    • Emergency department visits

    ADO: age, dyspnoea, airflow obstruction; BODEX: body mass index (BMI), airflow obstruction, dyspnoea, exacerbation; DOSE: dyspnoea, obstruction, smoking, exacerbation; LACE: length of hospital stay, acuity of admission, comorbidities, emergency department use; FEV1: forced expiratory volume in 1 s; % pred: % predicted; mMRC: modified Medical Research Council.

    • TABLE 3

      PEARL (previous admissions, extended Medical Research Council (eMRC) dyspnoea score, age, right-sided heart failure, left-sided heart failure) indices and weighting [68]

      Weighting
      Previous admissions (≥2)3
      eMRC dyspnoea score 41
      eMRC dyspnoea score 5a2
      eMRC dyspnoea score 5b3
      Age ⩾80 years1
      Left ventricular failure1
      Right ventricular failure1
      Maximum PEARL score9
    • TABLE 4

      Components of the British Thoracic Society (BTS) COPD discharge care bundle [125]

      1. Review patient's medications and demonstrate use of inhalers

      2. Provide written self-management plan and emergency drug pack

      3. Assess and offer referral for smoking cessation

      4. Assess for suitability of pulmonary rehabilitation

      5. Arrange follow-up call within 72 h of discharge

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    Vol 6 Issue 2 Table of Contents
    ERJ Open Research: 6 (2)
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    Predicting and preventing hospital readmission for exacerbations of COPD
    Chia Wei Kong, Tom M.A. Wilkinson
    ERJ Open Research Apr 2020, 6 (2) 00325-2019; DOI: 10.1183/23120541.00325-2019

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    Predicting and preventing hospital readmission for exacerbations of COPD
    Chia Wei Kong, Tom M.A. Wilkinson
    ERJ Open Research Apr 2020, 6 (2) 00325-2019; DOI: 10.1183/23120541.00325-2019
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    Jump To

    • Article
      • Abstract
      • Abstract
      • Introduction
      • Risk factors for readmissions
      • Predictive models of readmission
      • Readmission in the context of treatment and processes of care
      • Specific interventions for COPD
      • Clinical service strategies and care bundles
      • Conclusion
      • Footnotes
      • References
    • Figures & Data
    • Info & Metrics
    • PDF

    Subjects

    • COPD and smoking
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