PDF(Pubmed)
Abstract：
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).
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).
摘要：
■慢性阻塞性肺疾病（COPD）住院后的再入院率惊人地高，频繁的再入院代表着更高的死亡风险和沉重的经济负担。然而,关于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再入院率及其潜在危险因素。
■检索了8个电子数据库，以确定从开始到2022年8月1日关于COPD再入院的相关观察性研究。采用纽卡斯尔-渥太华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再入院率和潜在危险因素。
■共纳入28项研究，其中27项和8项研究总结了30天和90天的全因再入院，分别。合并的30天和90天内的全因COPD再入院率分别为18%和31%。分别。世界卫生组织区域最初被认为是异质性的来源。我们确定了酒精的使用，排放目的地,前一年两次或两次以上住院，以及心力衰竭等合并症，糖尿病,慢性肾病,贫血,癌症,或肿瘤作为全因再入院的潜在危险因素，而女性和肥胖是保护因素。
■COPD患者的全因再入院率很高，我们还发现了一些潜在的风险因素。因此,迫切需要加强早期随访和有针对性的干预措施，出院后调整或避免危险因素，从而减轻因频繁再入院而造成的重大卫生经济负担。
■该系统评价和荟萃分析方案在PROSPERO进行了前瞻性注册（编号：CRD42022369894）。
■本研究旨在系统总结出院后30天和90天内全因COPD再入院率及其潜在危险因素。
■检索了8个电子数据库，以确定从开始到2022年8月1日关于COPD再入院的相关观察性研究。采用纽卡斯尔-渥太华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再入院率和潜在危险因素。
■共纳入28项研究，其中27项和8项研究总结了30天和90天的全因再入院，分别。合并的30天和90天内的全因COPD再入院率分别为18%和31%。分别。世界卫生组织区域最初被认为是异质性的来源。我们确定了酒精的使用，排放目的地,前一年两次或两次以上住院，以及心力衰竭等合并症，糖尿病,慢性肾病,贫血,癌症,或肿瘤作为全因再入院的潜在危险因素，而女性和肥胖是保护因素。
■COPD患者的全因再入院率很高，我们还发现了一些潜在的风险因素。因此,迫切需要加强早期随访和有针对性的干预措施，出院后调整或避免危险因素，从而减轻因频繁再入院而造成的重大卫生经济负担。
■该系统评价和荟萃分析方案在PROSPERO进行了前瞻性注册（编号：CRD42022369894）。
