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Psychological disorders increase risk for hospital readmission in patients with COPD

Psychological disorders such as depression and anxiety appeared associated with higher 30-day hospital readmission rates in Medicare beneficiaries with COPD, according to study results.

“These psychological disorders are more likely to predict 30-day readmission than other significant factors like male gender and measures of disease severity such as length of hospital stay, ICU stay and use of mechanical ventilation during the index hospitalization,” Gurinder P. Singh, MD, a fellow in the division of pulmonary, critical care and sleep medicine at University of Texas Medical Branch, and colleagues wrote.

Singh and colleagues reviewed data from 5% fee-for-service Medicare beneficiaries with COPD between 2001 and 2011 to determine if disorders such as depression and anxiety increased the risk for 30-day readmission in patients hospitalized for COPD.

The analysis included 80,088 fee-for-service Medicare beneficiaries; 30,218 had one or more psychological disorder.

Patients with COPD and existing psychological disorders (5.04 days) had a longer length of stay during hospitalization than patients without any disorders (4.8 days) (P < .0001) and had more discharges to a skilled nursing facility (20.96% vs. 10.03%, P < .0001).

Depression (24.15% vs. 16.91%), anxiety (25.38 vs. 17.15%), psychosis (25.34% vs. 17.68%), and alcohol abuse (26.49% vs. 17.84%) and drug abuse (27.9% vs. 17.86%) increased the likelihood of 30-day readmission in patients with COPD compared with patients without psychological disorders.

More research is needed to reduce the likelihood of readmission in patients with COPD and existing psychological disorders, according to the researchers.

“Due to scarce evidence in literature to support any interventions to reduce readmissions in COPD patients, hospitals and health care providers need more guidance to reduce readmission in COPD patients and it may not be practical to penalize hospitals for higher 30-day readmission rates,” the researchers wrote. – by Ryan McDonald

Disclosure: Singh reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.