Pulmonologist Follow-Up Visits After Hospitalization Are Crucial To Avoiding Re-Admission in COPD Patients

Patrícia Silva, PhD avatar

by Patrícia Silva, PhD |

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Researchers at Ben-Gurion University of the Negev and Soroka University Medical Center in Israel recently published in the journal CHEST the finding that patients with chronic obstructive pulmonary disease (COPD) who were hospitalized due to exacerbations related to the disease and who did not attend follow-up visits with a pulmonologist were at higher risk for hospital re-admission in the future. The study is entitled “The Association Between Hospital Readmission and Pulmonologist Follow-up Visits in Patients With COPD.

COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide, being the third leading cause of death in the United States. It is a progressive disease in which individuals develop serious problems in breathing with obstruction of the airways, shortness of breath (dyspnea), cough and acute exacerbations. Smoking is considered to be the leading cause of COPD and the disease can seriously impact the patient’s physical capacity, well-being and social functioning.

COPD exacerbations represent periods of increased disease activity, and these significantly contribute to disease progression, reduced health status, accelerated loss of lung function and increased mortality rates. It is estimated that COPD exacerbations are responsible for 500,000 hospital admissions every year, representing $18 billion in direct health-care costs.

In the study, researchers assessed the impact of COPD patients attending follow-up visits with pulmonologists after being discharged from the hospital in decreasing the readmission frequency. The team conducted a population-based retrospective cohort study where they analyzed data on 195 COPD patients who attended an Israeli hospital having been hospitalized between January 2004 and December 2010.

Researchers reported that 44.1% of the patients in the cohort analyzed had follow-up visits with pulmonologists within the 30 days after hospital discharge. The team found that many patients did not attend their follow-up appointments due to distant residence, a high number of previous hospitalizations in the last year, or no recommendation for a follow-up visit after hospital discharge. Remarkably, researchers found that not attending the follow-up visit was linked to a significant increase in the re-hospitalization risk, more precisely of 14% (almost three times higher) within the first month after initial discharge, and 7% within three months. Within a year, more than half of the COPD patients admitted in the hospital due to exacerbations were readmitted at least one time.

The research team concluded that early follow-up visits with pulmonologists after hospital discharge may reduce the re-hospitalization risk due to exacerbations in COPD patients. Therefore, the team recommends that COPD patients must have early post-hospital discharge visits with pulmonologists.

“The potential impact of this study on reducing the admission rate of patients with common respiratory diseases is high. Advising a patient to visit a chest physician after discharge may save the next admission and reduce the morbidity burden of this serious disease,” concluded the study’s senior author Dr. Nimrod Maimon in a news release.