Analysis of risk factors associated with hospital admission due to acute exacerbation of chronic obstructive pulmonary disease

NAN Hao-yu; LIU Xue-jun; QIAN Li

doi:10.3760/cma.j.issn.1673-4777.2013.11.016

Abstract：Objective To investigate the risk factors associated with hospital admission for acute exacerbation of obstructive pulmonary disease (AECOPD).Methods One hundred and twenty-seven outpatients with AECOPD from the First Hospital of Shanxi Medical University were investigated through a cross-sectional and observational study.They were divided into inpatient treatment group and ambulatory treatment according to treatment.First,we studied the four types of 23 possible factors with single-factor analysis,then the factors with P value below 0.05 in single-factor analysis were proceeded to perform the multiple-factor analysis with logistic regression.We analyzed the risk factors associated with hospital admission for AECOPD.Results The single-factor analysis showed that patients with at least one visit to the hospital emergency room(ER) in the previous year[70％ (35/50)vs 22.1％ (17/77)],mucolytic cure[54％ (27/50) vs 28.6％ (22/77)],oxygen therapy[42.9％ (21/50) vs 10.4％ (8/77)),the number of visits to the ER[(2.0 ± 0.3) vs (0.6 ± 0.1)],PaO2 [(63 ± 11)mm Hg vs (72 ± 11) mm Hg],PaCO2 [(47±9)mm Hgvs (43 ±8)mm Hg],SaO2[(91±5)％ vs (94±3)％],Hb[(141±14)g/Lvs (149±14)g/L],WBC[(9.3±2.5) ×109/Lvs (8.1 ±2.2) ×109/L],the BODE index [(4.9±2.3) vs (3.0± 2.1)] and 6MWT [(315 ± 118) mvs (431 ± 117) m] were risk factors (P ＜ 0.05).According to the multiple-factor analysis of with Logistic regression analysis,there were 3 factors including the number of visits to the ER(OR:2.485,95％ CI:2.092-4.019),the BODE index (OR:3.303,95 ％ CI:3.054-5.610) and SaO2 (OR:0.658,95％ CI:0.561-0.967) (P ＜0.05).Conclusion Low SO2,high BODE index score and a greater number of visits to the ER may be the independent risk factors of hospital admission for AECOPD patients.