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ToolsWaeijen-Smit, Kiki, Crutsen, Mieke, Keene, Spencer, Miravitlles, Marc, Crisafulli, Ernesto, Torres, Antoni, Mueller, Christian, Schuetz, Philipp, Ringbæk, Thomas J., Fabbian, Fabio, Mekov, Evgeni, Harries, Timothy H., Lun, Chung-tat, Ergan, Begum, Esteban, Cristóbal, Quintana Lopez, Jose M., López-Campos, José Luis, Chang, Catherina L., Hancox, Robert J., Shafuddin, Eskandarain, Ellis, Hollie, Janson, Christer, Suppli Ulrik, Charlotte, Gudmundsson, Gunnar, Epstein, Danny, Dominguez, José, Lacoma, Alicia, Osadnik, Christian, Alia, Inmaculada, Spannella, Francesco, Karakurt, Zuhal, Mehravaran, Hossein, Utens, Cecile, de Kruif, Martijn D., Ko, Fanny Wai San, Trethewey, Samuel P., Turner, Alice M., Bumbacea, Dragos, Murphy, Patrick B., Vermeersch, Kristina, Zilberman-Itskovich, Shani, Steer, John, Echevarria, Carlos, Bourke, Stephen C., Lane, Nicholas, de Batlle, Jordi, Sprooten, Roy T. M., Russell, Richard, Faverio, Paola, Cross, Jane L., Prins, Hendrik J., Spruit, Martijn A., Simons, Sami O., Houben-Wilke, Sarah and Franssen, Frits M. E. (2024) Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients. ERJ Open Research, 10 (1). ISSN 2312-0541
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Abstract
Please note there is a correction available for this article: https://doi.org/10.1183/23120541.50838-2023 Background: Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods: A systematic review was performed identifying studies that reported in-hospital mortality, post-discharge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results: Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisations <12 months prior to the index event. Conclusions: This IPDMA stresses the poor outcomes and high heterogeneity of ECOPD-related hospitalisation across the world. Whilst global standardisation of the management and follow-up of ECOPD-related hospitalisation should be at the heart of future implementation research, policy makers should focus on reimbursing evidence-based therapies that decrease (recurrent) ECOPD.
| Item Type: | Article |
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| Additional Information: | This article has a correction (see : ERJ Open Research 2024 10(6): 50838-2023; DOI: https://doi.org/10.1183/23120541.50838-2023) In the originally published version of this article there was an error in the follow-up time and total number of readmissions in two datasets of the hospital readmission data subset. This concerned the datasets of Quintana et al. [1] and Lopez-Campos et al. [2]. Instead of a follow-up time of 365 days, the correct follow-up times were 60 and 90 days, respectively. In addition, instead of total readmission rates of 19.5% and 26.6%, the correct readmission rates were 26.0% and 35.1%, respectively. As a result, the median follow-up time in the hospital readmission data subset changed from 365 days to 90 days, whereas the overall readmission rate changed from 15 195 (32.8%, 95% CI 32.4–33.3%) to 16 646 (36.0%, 95% CI 35.5–36.4%). Corrections have been made accordingly to the Results, including table S7 and figure S8, and to the Discussion. In addition, there was an error in the coding for the 30-, 90- and 365-day categories related to post-discharge mortality and hospital readmission. The initial coding failed to capture all possible conditional statements needed to accurately capture outcome statuses based on follow-up times. This was particularly relevant in studies where the exact time until the event was not known, and was instead represented by the predetermined, or set, study follow-up period. These corrections altered the pooled 30-, 90- and 365-day post-discharge mortality and hospital readmission rates from 1.8% to 2.0%, from 5.5% to 6.4%, from 10.9% to 12.2%, and from 7.1% to 11.8%, from 12.6% to 26.5% and from 32.1% to 38.2%, respectively. Corrections have been made accordingly to the Abstract, Results (including figures 5 and 7), and to the Discussion. Figures S3 and S7 have been aligned to display only the percentages of patients with a known time of event, categorised by time intervals during follow-up after hospital discharge from the index event. Importantly, the corrections do not change the scientific conclusions drawn in the article. // Data sharing statement: Access to the extracted data, and/or the codes developed for this analysis, are possible upon reasonable request. Such queries may be directed towards the senior author. |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Centres > Population Health (former - to 2025) Faculty of Medicine and Health Sciences > Research Centres > Public Health |
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| Depositing User: | LivePure Connector |
| Date Deposited: | 04 Mar 2024 18:39 |
| Last Modified: | 30 Jul 2025 10:27 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/94567 |
| DOI: | 10.1183/23120541.00838-2023 |
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