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.	袁晓宇, 罗刚, 杨练, 等. 关于社区卫生诊断助力慢性病健康管理工作的思考与建议. 中国卫生事业管理, 2022, 39(2): 93-96,156.
2.	张百艺, 赵妹, 李明, 等. 老年慢性阻塞性肺疾病患者急性加重再入院现况及影响因素研究. 解放军护理杂志, 2021, 38(12): 26-29.
3.	胡灏, 方正, 邓兵, 等. 外周血人类软骨糖蛋白39联合嗜酸性粒细胞对慢性阻塞性肺疾病急性加重再入院风险预评估作用分析. 临床军医杂志, 2023, 51(1): 23-26.
4.	孟诗迪, 王薇, 殷鹏, 等. 2005年与2020年中国60岁及以上老年人4类重大慢性病疾病负担分析. 中国慢性病预防与控制, 2022, 30(5): 321-326.
5.	杨艳霞, 顾馨雨, 龚浩, 等. 慢性阻塞性肺疾病病人出院后30d内非计划再入院研究进展. 护理研究, 2023, 37(8): 1426-1430.
6.	乔峰. 医院-社区-家庭联动护理模式对COPD稳定期患者再入院率及护理工作满意度的影响. 黔南民族医专学报, 2021, 34(1): 46-48.
7.	韩祺. 出院31d内非计划再入院病人疾病种类、间隔天数与影响因素分析. 护理研究, 2020, 34(16): 2862-2867.
8.	贾方容, 袁平乔, 姚丽, 等. 慢性阻塞性肺疾病加重期病人30d非计划再入院研究进展. 护理研究, 2022, 36(14): 2538-2542.
9.	刘莹, 徐蕾, 毕薇, 等. 某三甲医院慢性阻塞性肺疾病患者出院1年内再入院情况及影响因素分析. 中华全科医学, 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.	李加樱, 曾雪涛, 周晨, 等. 合并衰弱的COPD患者30d内再入院预测模型的构建. 国际呼吸杂志, 2022, 42(20): 1550-1555.
14.	周寅川, 荣蓉, 黄祎丹, 等. 慢性阻塞性肺疾病急性加重期患者出院后30d内再入院的影响因素分析及Nomogram模型构建. 实用心脑肺血管病杂志, 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.	许汝福. Logistic回归变量筛选及回归方法选择实例分析. 中国循证医学杂志, 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, 徐伟, 等. 吸烟对慢性阻塞性肺疾病及呼吸道症状的影响. 中华疾病控制杂志, 2020, 24(1): 46-51,56.
24.	黄书花, 张玉娇, 马玮, 等. 老年慢性支气管哮喘急性发作影响因素. 中国老年学杂志, 2022, 42(16): 4098-4101.
25.	李雄波, 吴红霞, 张西洋, 等. COPD患者再入院影响因素的Meta分析. 医学信息, 2023, 36(13): 31-37.
26.	杨丽芬, 杨添文, 任朝凤, 等. 督导戒烟对吸烟慢性阻塞性肺疾病患者CAT、mMRC、SGRQ评分及再入院风险的随机对照研究. 中国呼吸与危重监护杂志, 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.	陈华萍, 胡明冬, 张君国, 等. 慢性阻塞性肺疾病合并症及其对预后的影响. 解放军医学杂志, 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.	张瑞, 吴珍珍, 常艳, 等. 老年慢性阻塞性肺疾病患者30天内急性加重再入院风险预测模型的构建与验证. 中国呼吸与危重监护杂志, 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.	李育莲, 李红. 慢性阻塞性肺疾病患者长期家庭氧疗护理的研究进展. 中华护理杂志, 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.	黄光成, 周良, 石建伟, 等. 机器学习算法在疾病风险预测中的应用与比较. 中国卫生资源, 2020, 23(4): 432-436.

1. 袁晓宇, 罗刚, 杨练, 等. 关于社区卫生诊断助力慢性病健康管理工作的思考与建议. 中国卫生事业管理, 2022, 39(2): 93-96,156.
2. 张百艺, 赵妹, 李明, 等. 老年慢性阻塞性肺疾病患者急性加重再入院现况及影响因素研究. 解放军护理杂志, 2021, 38(12): 26-29.
3. 胡灏, 方正, 邓兵, 等. 外周血人类软骨糖蛋白39联合嗜酸性粒细胞对慢性阻塞性肺疾病急性加重再入院风险预评估作用分析. 临床军医杂志, 2023, 51(1): 23-26.
4. 孟诗迪, 王薇, 殷鹏, 等. 2005年与2020年中国60岁及以上老年人4类重大慢性病疾病负担分析. 中国慢性病预防与控制, 2022, 30(5): 321-326.
5. 杨艳霞, 顾馨雨, 龚浩, 等. 慢性阻塞性肺疾病病人出院后30d内非计划再入院研究进展. 护理研究, 2023, 37(8): 1426-1430.
6. 乔峰. 医院-社区-家庭联动护理模式对COPD稳定期患者再入院率及护理工作满意度的影响. 黔南民族医专学报, 2021, 34(1): 46-48.
7. 韩祺. 出院31d内非计划再入院病人疾病种类、间隔天数与影响因素分析. 护理研究, 2020, 34(16): 2862-2867.
8. 贾方容, 袁平乔, 姚丽, 等. 慢性阻塞性肺疾病加重期病人30d非计划再入院研究进展. 护理研究, 2022, 36(14): 2538-2542.
9. 刘莹, 徐蕾, 毕薇, 等. 某三甲医院慢性阻塞性肺疾病患者出院1年内再入院情况及影响因素分析. 中华全科医学, 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. 李加樱, 曾雪涛, 周晨, 等. 合并衰弱的COPD患者30d内再入院预测模型的构建. 国际呼吸杂志, 2022, 42(20): 1550-1555.
14. 周寅川, 荣蓉, 黄祎丹, 等. 慢性阻塞性肺疾病急性加重期患者出院后30d内再入院的影响因素分析及Nomogram模型构建. 实用心脑肺血管病杂志, 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. 许汝福. Logistic回归变量筛选及回归方法选择实例分析. 中国循证医学杂志, 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, 徐伟, 等. 吸烟对慢性阻塞性肺疾病及呼吸道症状的影响. 中华疾病控制杂志, 2020, 24(1): 46-51,56.
24. 黄书花, 张玉娇, 马玮, 等. 老年慢性支气管哮喘急性发作影响因素. 中国老年学杂志, 2022, 42(16): 4098-4101.
25. 李雄波, 吴红霞, 张西洋, 等. COPD患者再入院影响因素的Meta分析. 医学信息, 2023, 36(13): 31-37.
26. 杨丽芬, 杨添文, 任朝凤, 等. 督导戒烟对吸烟慢性阻塞性肺疾病患者CAT、mMRC、SGRQ评分及再入院风险的随机对照研究. 中国呼吸与危重监护杂志, 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. 陈华萍, 胡明冬, 张君国, 等. 慢性阻塞性肺疾病合并症及其对预后的影响. 解放军医学杂志, 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. 张瑞, 吴珍珍, 常艳, 等. 老年慢性阻塞性肺疾病患者30天内急性加重再入院风险预测模型的构建与验证. 中国呼吸与危重监护杂志, 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. 李育莲, 李红. 慢性阻塞性肺疾病患者长期家庭氧疗护理的研究进展. 中华护理杂志, 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. 黄光成, 周良, 石建伟, 等. 机器学习算法在疾病风险预测中的应用与比较. 中国卫生资源, 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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