COPD: Depressed Patients More Likely to Need Readmission

Depression appears to be a risk factor for patients who have both that condition and chronic obstructive pulmonary disease. These patients are more likely to be readmitted to a hospital with acute episodes of COPD, Alabama researchers report.

Chronic obstructive pulmonary disease (COPD) can come with many co-morbidities. A

recent study found that patients with COPD who are depressed are more likely to be readmitted to the hospital for acute exacerbation of their COPD. Written by Anand S. Iyer, MD, of the Division of Pulmonary, Allergy, and Critical Care in the Department of Medicine and UAB Lung Health Center at the University of Alabama at Birmingham (UAB) and colleagues, the study was published in Annals of the American Thoracic Society on November 24, 2015.

The researchers examined the medical records of 422 COPD patients who were admitted to the UAB Hospital between November 2010 and October 2012. Inclusion criteria were a primary diagnosis of COPD, experience of an acute exacerbation; and having no respiratory illnesses other than COPD. Laboratory values, vital signs, immunization status, and tobacco cessation counseling were recorded. The researchers “investigated risk factors for both short- and long-term readmission for acute exacerbation of COPD.”

Of the 422 patients included in the study, 132 were readmitted within one year. Among those readmitted, the researchers found a more frequent occurrence of GERD, more depression and anxiety, less tobacco cessation counseling, and higher sodium levels. When the researchers adjusted for variables, “depression remained significantly associated with increased risk of one-year readmission,” while “tobacco cessation counseling was associated with reduced risk of one-year readmission.” An analysis of short-term readmissions, both 30- and 90-days also showed that depression was a significant increased risk factor.

The results of this study are limited because it is a “retrospective study based on administrative data from a single center.” Despite those limitations, the findings are valuable. The researchers conclude “As both depression and smoking status are potentially modifiable, they may be valuable targets for interventions aimed to reduced COPD admissions.”