Examining 30-day COPD readmissions through the emergency department

This article presents the methodology and findings of a retrospective cohort study conducted in Michigan, a state with some of the highest rates of COPD in the United States. The aims of the analysis were to examine readmission in COPD patients who came through the emergency department (ED) and predictors of length of stay for those readmitted. The authors discovered that 82 percent of those first admitted for COPD through the ED were readmitted within 30 days (N = 1,294 patients). They identified several independent predictors of ED readmission, including prescriptions for certain medications (e.g., albuterol, inhaled steroids), the patient’s chief complaint being breathing difficulty as well as the Charlson score (a comorbidities assessment). Of the patients who came to the ED with a chief complaint of breathing difficulty, 91 percent were readmitted through the ED; of that 91 percent, 84 percent stayed in the hospital longer than 48 hours. Also addressed are independent predictors of readmission in this subsample, including increased pulse rate. The authors discuss the implications of these findings in using the ED to implement readmissions reduction strategies.