Influencing factors and predictive value of acute exacerbation re-hospitalization in elderly patients with stable chronic obstructive pulmonary disease
Objective:To investigate the factors associated with acute exacerbation re-hospitalization in elderly patients with stable chronic obstructive pulmonary disease(COPD)and to analyze preventive management strategies.Methods:A convenience sampling method was used to select 248 elderly patients with stable COPD who were hospitalized in our hospital from June 2021 to October 2023.The patients were divided into a re-hospitalization group and a control group based on whether they experienced acute exacerbation re-hospitalization within three months after discharge.A binary Logistic regression analysis model was employed to explore the influencing factors for acute exacerbation re-hospitalization in elderly patients with stable COPD.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of the related factors.Results:The rate of acute exacerbation re-hospitalization within three months after discharge in elderly patients with stable COPD was 24.2％(60/248).Binary Logistic regression analysis indicated that having two or more hospitalizations due to acute exacerbations of COPD in the past year and frailty were risk factors for acute exacerbation re-hospitalization,while good nutritional status and FEV1 were protective factors.The ROC curve showed that the number of hospitalizations due to acute exacerbations of COPD in the past year,frailty,nutritional status,and FEV1 all had certain predictive efficacy for acute exacerbation re-hospitalization,with areas under the curve(AUC)of 0.623,0.612,0.678,and 0.658,respectively.When these indicators were combined,the AUC was 0.886,indicating the highest predictive efficacy.Conclusion:The factors associated with acute exacerbation re-hospitalization in elderly patients with stable COPD include the number of hospitalizations due to acute exacerbations of COPD in the past year,frailty,nutritional status,and FEV1,all of which have certain predictive efficacy.
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