Em. Pouw et al., Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss, CLIN NUTR, 19(2), 2000, pp. 95-99
Aim: To identify risk factors for early nonelective readmission in patients
with chronic obstructive pulmonary disease, previously admitted for an exa
cerbation of their disease. Clinical characteristics were analysed with spe
cial emphasis on body weight on admission and weight changes during hospita
lization.
Methods: The computerized hospital database was used to select all hospital
admissions in 1994 and 1995 with exacerbation of chronic obstructive pulmo
nary disease as main discharge diagnosis. Cases were retained if they were
nonelectively readmitted within 14 days after prior discharge, and if they
had no oedema. Controls were randomly selected from the discharge listing a
nd were not readmitted within 3 months. Cases and controls were matched on
several parameters including FEV1% predicted obtained during a stable phase
of the disease. Hospital charts were reviewed for clinical parameters on a
dmission, discharge and readmission.
Results: Fourteen cases were retained in the study. On admission, lung func
tion, blood gases and parameters describing morbidity and social factors, w
ere not different in cases and controls. The discharge procedure was adequa
te. During hospitalization the cases lost weight (mean+/-SD) (-1.6+/-1.9 kg
, P = 0.01), while controls remained weight stable. Using a matched pairs l
ogistic regression analysis, weight loss during hospitalization (P = 0.011)
and low BMI on admission (P = 0.046) were related to the increased risk of
unplanned readmission.
Conclusion: These findings provide further support for the concept that nut
ritional status is related to morbidity in COPD. (C) 2000 Harcourt Publishe
rs Ltd.