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Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis


Alqahtani, JS and Njoku, CM and Bereznicki, B and Wimmer, BC and Peterson, GM and Kinsman, L and Aldabayan, YS and Alrajeh, AM and Aldhahir, AM and Mandal, S and Hurst, JR, Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis, European Respiratory Review, 29, (156) pp. 1-16. ISSN 0905-9180 (2020) [Refereed Article]


Copyright Statement

Copyright 2020 ERS. Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

DOI: doi:10.1183/16000617.0166-2019


Background: Readmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD.

Methods: We systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle–Ottawa Scale. We synthesised a narrative from eligible studies and conducted a metaanalysis where this was possible using a random-effects model.

Results: In total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged from 8.8–26.0% at 30 days and from 17.5–39.0% at 90 days. Our narrative synthesis showed that comorbidities, previous exacerbations and hospitalisations, and increased length of initial hospital stay were the major risk factors for readmission at 30 and 90 days. Pooled adjusted odds ratios (95% confidence intervals) revealed that heart failure (1.29 (1.22–1.37)), renal failure (1.26 (1.19–1.33)), depression (1.19 (1.05–1.34)) and alcohol use (1.11 (1.07–1.16)) were all associated with an increased risk of 30-day all-cause readmission, whereas being female was a protective factor (0.91 (0.88–0.94)).

Conclusions: Comorbidities, previous exacerbations and hospitalisation, and increased length of stay were significant risk factors for 30- and 90-day all-cause readmission after an index hospitalisation with an exacerbation of COPD.

Item Details

Item Type:Refereed Article
Keywords:chronic obstructive pulmonary disease, risk factors, hospital readmission, COPD, exacerbation
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacology and therapeutics
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Njoku, CM (Ms Maria Chidiamara Noku)
UTAS Author:Bereznicki, B (Dr Bonnie Bereznicki)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:139398
Year Published:2020
Web of Science® Times Cited:46
Deposited By:Pharmacy
Deposited On:2020-06-14
Last Modified:2022-08-25
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