AECOPD患者再入院的危险因素分析

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者再入院的影响因素。方法回顾性分析283例AECOPD患者临床资料,根据患者出院后90 d内是否非计划再入院分为再入院组75例和非再入院组208例,通过单因素及多因素logistic回归分析AECOPD患者再入院的影响因素。结果283例AECOPD患者出院90d内非计划性再入院率为26.50%。logistic回归分析:年龄高(OR=1.893,95%CI:1.121~2.757)、营养不良(OR=2.604,95%CI:1.245~4.019)、FEF75预计值升高(OR=1.365,95%CI:1.057~2.562)、过去1年急性加重次数≥2次(OR=2.071,95%CI:1.319~3.280)为AECOPD患者非计划性再入院的独立影响因素。文化程度高(OR=0.722,95%CI:0.501~0.943)、FEV1实际值升高(OR=0.513,95%CI:0.361~0.733)、坚持运动锻炼(OR=0.410,95%CI:0.282~0.741)为AECOPD患者再入院风险的保护因素。结论年龄高、文化程度低、营养不良、FEF75预计值升高、FEV1实际值下降、过去1年急性加重次数≥2次的AECOPD患者非计划性再入院的风险较高,长期坚持运动锻炼可以降低再入院风险。

Objective To explore the influencing factors of readmission of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 283 patients with AECOPD were investigated retrospectively.According to whether the patients were unplanned readmission within 90 days after discharge,they were divided into 75 cases in the readmission group and 208 cases in the non-readmission group.The influencing factors of readmission of patients with AECOPD were analyzed by univariate and multivariate logistic regression.Results 283 AECOPD patients had unplanned readmission within 90 days after discharge.The readmission rate was 26.50%.Logistic regression analysis showed that high age(OR=1.893,95%CI:1.121~2.757),malnutrition(OR=2.604,95%CI:1.245~4.019),increased expected value of fef75(OR=1.365,95%CI:1.057~2.562),number of acute exacerbations≥2 times in the past year(OR=2.071,95%CI:1.319~3.280)were independent influencing factors for unplanned readmission of AECOPD patients.High level of education(OR=0.722,95%CI:0.501~0.943),elevated FEV1(OR=0.513,95%CI:0.361~0.733)and physical exercise(OR=0.410,95%CI:0.282~0.741)were the protective factors for the risk of readmission in patients with AECOPD.Conclusion Patients with AECOPD with high age,low education level,malnutrition,increased expected fef75 value,decreased actual FEV1 value,and more than 2 times of acute exacerbation in the past year have a higher risk of unplanned readmission.Long term physical exercise can recuce the risk of readmission.