International Journal of COPD (May 2023)

Risk Factors of Readmission Within 90 Days for Chronic Obstructive Pulmonary Disease Patients with Frailty and Construction of an Early Warning Model

  • Li J,
  • Ma X,
  • Zeng X,
  • Zhou C,
  • Zhu T

Journal volume & issue
Vol. Volume 18
pp. 975 – 984

Abstract

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Jiaying Li,1,* Xiuqin Ma,1,* Xuetao Zeng,1,2 Chen Zhou,1 Taofeng Zhu1 1Department of Respiratory and Critical Care Medicine, The Yixing Hospital Affiliated to Jiangsu University, Yixing, Jiangsu, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The Affiliated Hospital to Jiangnan University, Wuxi, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Taofeng Zhu, Department of Respiratory and Critical Care Medicine, The Yixing Hospital Affiliated to Jiangsu University, No. 75 Tongzhenguan Road, Yixing, Jiangsu, 214200, People’s Republic of China, Tel +86-510-879210911, Fax +86-510-87921110, Email [email protected]: This study aimed to explore the risk factors for readmission within 90 d in Chronic Obstructive Pulmonary Disease (COPD) patients with frailty and construct a clinical warning model.Methods: COPD patients with frailty hospitalized in the Department of Respiratory and Critical Care Medicine of Yixing Hospital, Affiliated to Jiangsu University, were retrospectively collected from January 1, 2020, to June 30, 2022. Patients were divided into readmission and control groups according to readmission within 90 d. The clinical data of the two groups were evaluated by univariate and multivariate logistic regression analyses to identify readmission risk factors within 90 d in COPD patients with frailty. Then, a risk quantitative early warning model was constructed. Finally, the model’s prediction efficiency was evaluated, and external verification was carried out.Results: The multivariate logistic regression analysis showed that BMI, number of hospitalizations in the past year ≥ 2, CCI, REFS, and 4MGS were independent risk factors for readmission within 90 d in COPD patients with frailty. The early warning model for these patients was established as follows: Logit (p) = − 1.896 + (− 0.166 × BMI) + (0.969 × number of hospitalizations in the past year ≥ 2) + (0.265 × CCI) + (0.405 × REFS) + (− 3.209 × 4MGS), and presented an area under the ROC curve (AUC) of 0.744 [95% CI: 0.687– 0.801]. The AUC of the external validation cohort was 0.737 (95% CI: 0.648– 0.826), and the AUC of the LACE warning model was 0.657 (95% CI:0.552– 0.762).Conclusion: The BMI, number of hospitalizations in the past year ≥ 2, CCI, REFS, and 4MGS were independent risk factors for readmission within 90 d in COPD patients with frailty. The early warning model presented a moderate predictive value for assessing the risk of readmission within 90 d in these patients.Keywords: chronic obstructive pulmonary disease, frailty, readmission, risk factors, warning model

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