Risk prediction models for readmission within 30 days after discharge in patients with chronic obstructive pulmonary disease: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

DU Qiufeng ¹ ,  JIANG Yunlan ^1,2 , LI Tao ¹ , YI Xiaodong ¹ , SONG Shuang ¹ , KANG Jing ¹

1. College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;
2. Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, P. R. China;

Corresponding?author：

JIANG Yunlan, Email: 18980880152@163.com

Keywords：

Chronic obstructive pulmonary disease; Readmission; Risk prediction; Model; Systematic review

DOI：

10.7507/1672-2531.202306041

Video：

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Objective To systematically review the risk prediction models for readmission within 30 days after discharge in patients with chronic obstructive pulmonary disease (COPD), and provide a reference for clinical selection of risk assessment tools. Methods Databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library were searched for literature on this topic. The search time was from the inception of the database to April 25, 2023. Literature screening and data extraction were performed by two researchers independently. The risk of bias and applicability of the included literature were evaluated using the risk of bias assessment tool for predictive model studies. Results A total of 8 studies were included, including 14 risk prediction models for 30-day readmission of COPD patients after discharge. The total sample size was 125~8 263, the number of outcome events was 24~741, and the area under the receiver operating characteristic curve was 0.58~0.918. The top five most common predictors included in the model were smoking, comorbidities, age, education level, and home oxygen therapy. Although five studies had good applicability, all eight studies had a certain risk of bias. This is mainly due to the small sample size of the model, lack of reporting of blinding, lack of external validation, and inappropriate handling of missing data. Conclusion The overall prediction performance of the risk prediction model for 30-day readmission of patients with COPD after discharge is good, but the overall research quality is low. In the future, the model should be continuously improved to provide a scientific assessment tool for the early clinical identification of patients with COPD at high risk of readmission within 30 days after discharge.

Citation： DU Qiufeng, JIANG Yunlan, LI Tao, YI Xiaodong, SONG Shuang, KANG Jing. Risk prediction models for readmission within 30 days after discharge in patients with chronic obstructive pulmonary disease: a systematic review. Chinese Journal of Evidence-Based Medicine, 2024, 24(1): 49-55. doi: 10.7507/1672-2531.202306041 Copy

1.	袁曉宇, 羅剛, 楊練, 等. 關于社區衛生診斷助力慢性病健康管理工作的思考與建議. 中國衛生事業管理, 2022, 39(2): 93-96,156.
2.	張百藝, 趙妹, 李明, 等. 老年慢性阻塞性肺疾病患者急性加重再入院現況及影響因素研究. 解放軍護理雜志, 2021, 38(12): 26-29.
3.	胡灝, 方正, 鄧兵, 等. 外周血人類軟骨糖蛋白39聯合嗜酸性粒細胞對慢性阻塞性肺疾病急性加重再入院風險預評估作用分析. 臨床軍醫雜志, 2023, 51(1): 23-26.
4.	孟詩迪, 王薇, 殷鵬, 等. 2005年與2020年中國60歲及以上老年人4類重大慢性病疾病負擔分析. 中國慢性病預防與控制, 2022, 30(5): 321-326.
5.	楊艷霞, 顧馨雨, 龔浩, 等. 慢性阻塞性肺疾病病人出院后30d內非計劃再入院研究進展. 護理研究, 2023, 37(8): 1426-1430.
6.	喬峰. 醫院-社區-家庭聯動護理模式對COPD穩定期患者再入院率及護理工作滿意度的影響. 黔南民族醫專學報, 2021, 34(1): 46-48.
7.	韓祺. 出院31d內非計劃再入院病人疾病種類、間隔天數與影響因素分析. 護理研究, 2020, 34(16): 2862-2867.
8.	賈方容, 袁平喬, 姚麗, 等. 慢性阻塞性肺疾病加重期病人30d非計劃再入院研究進展. 護理研究, 2022, 36(14): 2538-2542.
9.	劉瑩, 徐蕾, 畢薇, 等. 某三甲醫院慢性阻塞性肺疾病患者出院1年內再入院情況及影響因素分析. 中華全科醫學, 2023, 21(1): 70-72, 111.
10.	Moons KG, de Groot JA, Bouwmeester W, et al. Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist. PLoS Med, 2014, 11(10): e1001744.
11.	Moons KGM, Wolff RF, Riley RD, et al. PROBAST: a tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration. Ann Intern Med, 2019, 170(1): W1-W33.
12.	Wolff RF, Moons KGM, Riley RD, et al. PROBAST: A tool to assess the risk of bias and applicability of prediction model studies. Ann Intern Med, 2019, 170(1): 51-58.
13.	李加櫻, 曾雪濤, 周晨, 等. 合并衰弱的COPD患者30d內再入院預測模型的構建. 國際呼吸雜志, 2022, 42(20): 1550-1555.
14.	周寅川, 榮蓉, 黃祎丹, 等. 慢性阻塞性肺疾病急性加重期患者出院后30d內再入院的影響因素分析及Nomogram模型構建. 實用心腦肺血管病雜志, 2020, 28(8): 57-63.
15.	Goto T, Yoshida K, Faridi MK, et al. Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation. BMC Pulm Med, 2020, 20(1): 107.
16.	Lee S, Wang SJ, Bain PA, et al. Reducing COPD readmissions: a causal bayesian network model. IEEE Robot Autom Lett, 2018, 3(4): 4046-4053.
17.	Li M, Cheng K, Ku K, et al. Modelling 30-day hospital readmission after discharge for COPD patients based on electronic health records. NPJ Prim Care Respir Med, 2023, 33(1): 16.
18.	Sharif R, Parekh TM, Pierson KS, et al. Predictors of early readmission among patients 40 to 64 years of age hospitalized for chronic obstructive pulmonary disease. Ann Am Thorac Soc, 2014, 11(5): 685-694.
19.	Zhang R, Lu H, Chang Y, et al. Prediction of 30-day risk of acute exacerbation of readmission in elderly patients with COPD based on support vector machine model. BMC Pulm Med, 2022, 22(1): 292.
20.	Crisafulli E, Torres A, Huerta A, et al. C-reactive protein at discharge, diabetes mellitus and ≥ 1 hospitalization during previous year predict early readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. COPD, 2015, 12(3): 306-314.
21.	許汝福. Logistic回歸變量篩選及回歸方法選擇實例分析. 中國循證醫學雜志, 2016, 16(11): 1360-1364.
22.	Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. Ann Intern Med, 2015, 162(1): 55-63.
23.	查震球, 何玉琢, 徐偉, 等. 吸煙對慢性阻塞性肺疾病及呼吸道癥狀的影響. 中華疾病控制雜志, 2020, 24(1): 46-51,56.
24.	黃書花, 張玉嬌, 馬瑋, 等. 老年慢性支氣管哮喘急性發作影響因素. 中國老年學雜志, 2022, 42(16): 4098-4101.
25.	李雄波, 吳紅霞, 張西洋, 等. COPD患者再入院影響因素的Meta分析. 醫學信息, 2023, 36(13): 31-37.
26.	楊麗芬, 楊添文, 任朝鳳, 等. 督導戒煙對吸煙慢性阻塞性肺疾病患者CAT、mMRC、SGRQ評分及再入院風險的隨機對照研究. 中國呼吸與危重監護雜志, 2021, 20(11): 761-767.
27.	Alqahtani JS, Njoku CM, Bereznicki B, et al. Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis. Eur Respir Rev, 2020, 29(156): 190166.
28.	陳華萍, 胡明冬, 張君國, 等. 慢性阻塞性肺疾病合并癥及其對預后的影響. 解放軍醫學雜志, 2020, 45(8): 834-839.
29.	Spece LJ, Epler EM, Donovan LM, et al. Role of comorbidities in treatment and outcomes after chronic obstructive pulmonary disease exacerbations. Ann Am Thorac Soc, 2018, 15(9): 1033-1038.
30.	張瑞, 吳珍珍, 常艷, 等. 老年慢性阻塞性肺疾病患者30天內急性加重再入院風險預測模型的構建與驗證. 中國呼吸與危重監護雜志, 2021, 20(7): 457-464.
31.	Sarkar M, Madabhavi I, Kadakol N. Oxygen-induced hypercapnia: physiological mechanisms and clinical implications. Monaldi Arch Chest Dis, 2022, 93(3).
32.	Kim JK, Jang SH, Park S, et al. Current situation of home oxygen therapy for chronic obstructive pulmonary disease patients in Korea. J Korean Med Sci, 2020, 35(4): e12.
33.	Ringbaek TJ, Viskum K, Lange P. Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease. Eur Respir J, 2002, 20(1): 38-42.
34.	Mazzarin C, Kovelis D, Biazim S, et al. Physical inactivity, functional status and exercise capacity in COPD patients receiving home-based oxygen therapy. COPD, 2018, 15(3): 271-276.
35.	李育蓮, 李紅. 慢性阻塞性肺疾病患者長期家庭氧療護理的研究進展. 中華護理雜志, 2019, 54(11): 1746-1751.
36.	Wiles SP, Aboussouan LS, Mireles-Cabodevila E. Noninvasive positive pressure ventilation in stable patients with COPD. Curr Opin Pulm Med, 2020, 26(2): 175-185.
37.	Njoku CM, Wimmer BC, Peterson GM, et al. Hospital readmission due to chronic obstructive pulmonary disease: a longitudinal study. Int J Health Policy Manag, 2022, 11(11): 2533-2541.
38.	Wong AW, Gan WQ, Burns J, et al. Acute exacerbation of chronic obstructive pulmonary disease: influence of social factors in determining length of hospital stay and readmission rates. Can Respir J, 2008, 15(7): 361-364.
39.	黃光成, 周良, 石建偉, 等. 機器學習算法在疾病風險預測中的應用與比較. 中國衛生資源, 2020, 23(4): 432-436.

1. 袁曉宇, 羅剛, 楊練, 等. 關于社區衛生診斷助力慢性病健康管理工作的思考與建議. 中國衛生事業管理, 2022, 39(2): 93-96,156.
2. 張百藝, 趙妹, 李明, 等. 老年慢性阻塞性肺疾病患者急性加重再入院現況及影響因素研究. 解放軍護理雜志, 2021, 38(12): 26-29.
3. 胡灝, 方正, 鄧兵, 等. 外周血人類軟骨糖蛋白39聯合嗜酸性粒細胞對慢性阻塞性肺疾病急性加重再入院風險預評估作用分析. 臨床軍醫雜志, 2023, 51(1): 23-26.
4. 孟詩迪, 王薇, 殷鵬, 等. 2005年與2020年中國60歲及以上老年人4類重大慢性病疾病負擔分析. 中國慢性病預防與控制, 2022, 30(5): 321-326.
5. 楊艷霞, 顧馨雨, 龔浩, 等. 慢性阻塞性肺疾病病人出院后30d內非計劃再入院研究進展. 護理研究, 2023, 37(8): 1426-1430.
6. 喬峰. 醫院-社區-家庭聯動護理模式對COPD穩定期患者再入院率及護理工作滿意度的影響. 黔南民族醫專學報, 2021, 34(1): 46-48.
7. 韓祺. 出院31d內非計劃再入院病人疾病種類、間隔天數與影響因素分析. 護理研究, 2020, 34(16): 2862-2867.
8. 賈方容, 袁平喬, 姚麗, 等. 慢性阻塞性肺疾病加重期病人30d非計劃再入院研究進展. 護理研究, 2022, 36(14): 2538-2542.
9. 劉瑩, 徐蕾, 畢薇, 等. 某三甲醫院慢性阻塞性肺疾病患者出院1年內再入院情況及影響因素分析. 中華全科醫學, 2023, 21(1): 70-72, 111.
10. Moons KG, de Groot JA, Bouwmeester W, et al. Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist. PLoS Med, 2014, 11(10): e1001744.
11. Moons KGM, Wolff RF, Riley RD, et al. PROBAST: a tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration. Ann Intern Med, 2019, 170(1): W1-W33.
12. Wolff RF, Moons KGM, Riley RD, et al. PROBAST: A tool to assess the risk of bias and applicability of prediction model studies. Ann Intern Med, 2019, 170(1): 51-58.
13. 李加櫻, 曾雪濤, 周晨, 等. 合并衰弱的COPD患者30d內再入院預測模型的構建. 國際呼吸雜志, 2022, 42(20): 1550-1555.
14. 周寅川, 榮蓉, 黃祎丹, 等. 慢性阻塞性肺疾病急性加重期患者出院后30d內再入院的影響因素分析及Nomogram模型構建. 實用心腦肺血管病雜志, 2020, 28(8): 57-63.
15. Goto T, Yoshida K, Faridi MK, et al. Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation. BMC Pulm Med, 2020, 20(1): 107.
16. Lee S, Wang SJ, Bain PA, et al. Reducing COPD readmissions: a causal bayesian network model. IEEE Robot Autom Lett, 2018, 3(4): 4046-4053.
17. Li M, Cheng K, Ku K, et al. Modelling 30-day hospital readmission after discharge for COPD patients based on electronic health records. NPJ Prim Care Respir Med, 2023, 33(1): 16.
18. Sharif R, Parekh TM, Pierson KS, et al. Predictors of early readmission among patients 40 to 64 years of age hospitalized for chronic obstructive pulmonary disease. Ann Am Thorac Soc, 2014, 11(5): 685-694.
19. Zhang R, Lu H, Chang Y, et al. Prediction of 30-day risk of acute exacerbation of readmission in elderly patients with COPD based on support vector machine model. BMC Pulm Med, 2022, 22(1): 292.
20. Crisafulli E, Torres A, Huerta A, et al. C-reactive protein at discharge, diabetes mellitus and ≥ 1 hospitalization during previous year predict early readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. COPD, 2015, 12(3): 306-314.
21. 許汝福. Logistic回歸變量篩選及回歸方法選擇實例分析. 中國循證醫學雜志, 2016, 16(11): 1360-1364.
22. Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. Ann Intern Med, 2015, 162(1): 55-63.
23. 查震球, 何玉琢, 徐偉, 等. 吸煙對慢性阻塞性肺疾病及呼吸道癥狀的影響. 中華疾病控制雜志, 2020, 24(1): 46-51,56.
24. 黃書花, 張玉嬌, 馬瑋, 等. 老年慢性支氣管哮喘急性發作影響因素. 中國老年學雜志, 2022, 42(16): 4098-4101.
25. 李雄波, 吳紅霞, 張西洋, 等. COPD患者再入院影響因素的Meta分析. 醫學信息, 2023, 36(13): 31-37.
26. 楊麗芬, 楊添文, 任朝鳳, 等. 督導戒煙對吸煙慢性阻塞性肺疾病患者CAT、mMRC、SGRQ評分及再入院風險的隨機對照研究. 中國呼吸與危重監護雜志, 2021, 20(11): 761-767.
27. Alqahtani JS, Njoku CM, Bereznicki B, et al. Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis. Eur Respir Rev, 2020, 29(156): 190166.
28. 陳華萍, 胡明冬, 張君國, 等. 慢性阻塞性肺疾病合并癥及其對預后的影響. 解放軍醫學雜志, 2020, 45(8): 834-839.
29. Spece LJ, Epler EM, Donovan LM, et al. Role of comorbidities in treatment and outcomes after chronic obstructive pulmonary disease exacerbations. Ann Am Thorac Soc, 2018, 15(9): 1033-1038.
30. 張瑞, 吳珍珍, 常艷, 等. 老年慢性阻塞性肺疾病患者30天內急性加重再入院風險預測模型的構建與驗證. 中國呼吸與危重監護雜志, 2021, 20(7): 457-464.
31. Sarkar M, Madabhavi I, Kadakol N. Oxygen-induced hypercapnia: physiological mechanisms and clinical implications. Monaldi Arch Chest Dis, 2022, 93(3).
32. Kim JK, Jang SH, Park S, et al. Current situation of home oxygen therapy for chronic obstructive pulmonary disease patients in Korea. J Korean Med Sci, 2020, 35(4): e12.
33. Ringbaek TJ, Viskum K, Lange P. Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease. Eur Respir J, 2002, 20(1): 38-42.
34. Mazzarin C, Kovelis D, Biazim S, et al. Physical inactivity, functional status and exercise capacity in COPD patients receiving home-based oxygen therapy. COPD, 2018, 15(3): 271-276.
35. 李育蓮, 李紅. 慢性阻塞性肺疾病患者長期家庭氧療護理的研究進展. 中華護理雜志, 2019, 54(11): 1746-1751.
36. Wiles SP, Aboussouan LS, Mireles-Cabodevila E. Noninvasive positive pressure ventilation in stable patients with COPD. Curr Opin Pulm Med, 2020, 26(2): 175-185.
37. Njoku CM, Wimmer BC, Peterson GM, et al. Hospital readmission due to chronic obstructive pulmonary disease: a longitudinal study. Int J Health Policy Manag, 2022, 11(11): 2533-2541.
38. Wong AW, Gan WQ, Burns J, et al. Acute exacerbation of chronic obstructive pulmonary disease: influence of social factors in determining length of hospital stay and readmission rates. Can Respir J, 2008, 15(7): 361-364.
39. 黃光成, 周良, 石建偉, 等. 機器學習算法在疾病風險預測中的應用與比較. 中國衛生資源, 2020, 23(4): 432-436.

Chinese Journal of Evidence-Based Medicine

Risk prediction models for readmission within 30 days after discharge in patients with chronic obstructive pulmonary disease: a systematic review

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