Predicting admission, a descriptive analysis of acute exacerbation chronic obstructive pulmonary disease (AECOPD) in the emergency department: a retrospective cohort study

Background: COPD is a common and preventable disease, characterized by persistent, progressive airflow limitation. When the disease progresses exacerbations occur, often with increasing frequency and intensity over time. Literature suggests 3%-16% of AECOPD require hospital admission. However, exact numbers of admission rates are lacking. Furthermore, readmissions are a major concern in the treatment of COPD. 30-days readmission rates vary between 14-23%. AECOPD result in 200.000 inpatient days annually in the Netherlands only, resulting in high healthcare costs. Objectives: Little is known about epidemiology of AECOPD in the emergency department (ED). Which patient parameters are indicative of hospital admission? The aim of this study is to contribute to the limited data available. Methods: This is a retrospective, observational study based on review of clinical records of all AECOPD patients presenting to the ED of the Haga Teaching Hospital between July 2014 to January 2015. Results: During the 6-month study period 100 COPD-related ED-visits were made. 81% of the ED-visits resulted in hospital admission. Patients with a pulse >100/min, an oxygen saturation Conclusions: Admission following an AECOPD-related ED-visit is common (81.0%) with a 30-day readmission rate of 16.9%. We revealed several patient-related factors associated with hospital admission. Insight in this population will raise awareness on the importance of a critical evaluation of admission of AECOPD-patients in the ED.