Influence of previous admissions on audit outcomes in patients admitted with acute exacerbation of COPD (AECOPD)

The National COPD Audit Programme ran an audit between February and April 2014: patient identifiers were used to link inpatient care of AECOPD to outcomes within 30/90 days of the index admission. Aims: We know that repeated hospital admission links to adverse patient outcomes. However, the relevance of previous hospital admission on COPD audit outcome data is not understood. We sought to assess effects of such events on our English audit cohort (n=12594). Methods: We obtained the number of COPD and non-COPD admissions for each of our cohort in the 90, 180 and 365 days prior to their index admission. We linked these prior admissions to the COPD audit index outcomes (mortality, length of stay [LoS] and readmission). Results: Previous/recent admissions were: - Common (19%, 27%, 36% had at least 1 COPD admission in the 3, 6 or 12 months prior to their index admission). - Associated more strongly with mortality after discharge (10.7% mortality for those with no admission in the 90 days prior to index admission versus 19.4% for those with five or more preadmissions [p - Associated with increased LoS of the index admission (23% of patients with no preadmissions versus 34% with five or more preadmissions had a LoS ˃ 7 days [p - Related strongly to subsequent readmission, particularly for those who had an admission during the 90 days prior to their index event (21% of patients with no preadmissions versus 79% with five or more preadmissions were readmitted within 30 days [p Conclusion: Particular attention should be given to the number and cause of previous admissions when managing patients with AECOPD.