Risk factors for all-cause hospital readmission following exacerbation of COPD: A systematic review and meta-analysis

Alqahtani, Jaber S.; Njoku, Chidiamara M.; Bereznicki, Bonnie; Wimmer, Barbara C.; Peterson, Gregory M.; Kinsman, Leigh; Aldabayan, Yousef S.; Alrajeh, Ahmed M.; Aldhahir, Abdulelah M.; Mandal, Swapna; Hurst, John R.

doi:10.1183/16000617.0166-2019

Cited by 149Chronic Obstructive Pulmonary Disease (COPD) ResearchAsthma and respiratory diseasesCystic Fibrosis Research Advances

Risk factors for all-cause hospital readmission following exacerbation of COPD: A systematic review and meta-analysis

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Alqahtani, Jaber S., Njoku, Chidiamara M., Bereznicki, Bonnie, Wimmer, Barbara C., Peterson, Gregory M., Kinsman, Leigh, Aldabayan, Yousef S., Alrajeh, Ahmed M. +3 more·2020·European Respiratory Review

DOI 10.1183/16000617.0166-2019PMC PMC9488450

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Abstract

BACKGROUND: Readmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD. METHODS: We systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis where this was possible using a random-effects model. RESULTS: In total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged from 8.8-26.0% at 30 days and from 17.5-39.0% at 90 days. Our narrative synthesis showed that comorbidities, previous exacerbations and hospitalisations, and increased length of initial hospital stay were the major risk factors for readmission at 30 and 90 days. Pooled adjusted odds ratios (95% confidence intervals) revealed that heart failure (1.29 (1.22-1.37)), renal failure (1.26 (1.19-1.33)), depression (1.19 (1.05-1.34)) and alcohol use (1.11 (1.07-1.16)) were all associated with an increased risk of 30-day all-cause readmission, whereas being female was a protective factor (0.91 (0.88-0.94)). CONCLUSIONS: Comorbidities, previous exacerbations and hospitalisation, and increased length of stay were significant risk factors for 30- and 90-day all-cause readmission after an index hospitalisation with an exacerbation of COPD.

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The 90-day readmission rate estimated for the UAE (35.9%) falls in the upper range of published international readmission rates.
“the 90-day readmission rate estimated for the UAE (35.9%) falls in the upper range of the published readmission rates [16,23].”
From Chronic Obstructive Pulmonary Disease in the Gulf Cooperation Council: Acute-Care Utilization and Medication Adherence: A PRISMA-ScR Scoping Review (2026) · cites this paper as [23]
Multimorbidity and greater disease severity are associated with an increased risk of hospital readmission following COPD exacerbation.
“These findings are consistent with the international COPD literature demonstrating that multimorbidity and greater disease severity are associated with an increased risk of hospital readmission following COPD exacerbation [23].”
From Chronic Obstructive Pulmonary Disease in the Gulf Cooperation Council: Acute-Care Utilization and Medication Adherence: A PRISMA-ScR Scoping Review (2026) · cites this paper as [23]
In other studies, the rate of 30-day readmissions was between 8.8% and 26.0%, and the rate of 90-day readmissions was between 17.5% and 39.0%.
“In other studies, the rate of 30-day readmissions was between 8.8% and 26.0%, whereas the rate of 90-day readmissions was between 17.5% and 39.0% [23].”
From Chronic Obstructive Pulmonary Disease in the Gulf Cooperation Council: Acute-Care Utilization and Medication Adherence: A PRISMA-ScR Scoping Review (2026) · cites this paper as [23]

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Agustí, A. G. N., Celli, B. R., Criner, G. J., Halpin, D. M. G., Anzueto, A., Barnes, P. J., Bourbeau, J., Han, M. K., Martínez, F. J., de, M. M., et al. (2023) · European Respiratory Journal · doi:10.1183/13993003.00239-2023 · Cited by 1,403 · see citing works
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary
Agustí, A. G. N., Celli, B. R., Criner, G. J., Halpin, D. M. G., Anzueto, A., Barnes, P. J., Bourbeau, J., Han, M. K., Martínez, F. J., de, M. M., et al. (2023) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202301-0106pp · Cited by 871 · see citing works
“A systematic review has shown that comorbidities, previous exacerbations and hospitalizations, and increased length of stay were signi ﬁ cant risk factors for 30-and 90-day all-cause readmission after a hospitalized COPD exacerbation (151).”
Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis
Alqahtani, J. S., Oyelade, T., Aldhahir, A. M., Mendes, R. G., Alghamdi, S. M., Miravitlles, M., Mandal, S., & Hurst, J. R. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255659 · Cited by 327 · see citing works
The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease
Adeloye, D., Elneima, O., Daines, L., Poinasamy, K., Quint, J. K., Walker, S., Brightling, C. E., Siddiqui, S., Hurst, J. R., Chalmers, J. D., et al. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00286-1 · Cited by 126 · see citing works
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary
Agustí, A. G. N., Celli, B. R., Criner, G. J., Halpin, D. M. G., Anzueto, A., Barnes, P. J., Bourbeau, J., Han, M. K., Martínez, F. J., de, M. M., et al. (2023) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2023.02.009 · Cited by 124 · see citing works
Readmission rate for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis
Ruan, H., Zhang, H., Wang, J., Zhao, H., Han, W., & Li, J. (2022) · Respiratory Medicine · doi:10.1016/j.rmed.2022.107090 · Cited by 101 · see citing works
Ambient heat exposure and COPD hospitalisations in England: a nationwide case-crossover study during 2007–2018
Konstantinoudis, G., Minelli, C., Vicedo-Cabrera, A., Ballester, J., Gasparrini, A., & Blangiardo, M. (2021) · Thorax · doi:10.1136/thoraxjnl-2021-218374 · Cited by 70 · see citing works
“The causes of acute exacerbation of COPD are established and include factors such as sex, age, COPD severity and comorbidities [3].”
Background
Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2
Antúnez, M. G., Míguez, A. M., Estrada, A. D. B., de la Calle, G. M., Monge, D. M., Boixeda, R., Ena, J., Pérez, C. M., Santos, J. M. A., & Lumbreras, C. (2021) · International Journal of COPD · doi:10.2147/copd.s276692 · Cited by 65 · see citing works
Prevalence, incidence, morbidity and mortality rates of COPD in Saudi Arabia: Trends in burden of COPD from 1990 to 2019
Alqahtani, J. S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268772 · Cited by 66 · see citing works
Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients
Waeijen-Smit, K., Crutsen, M., Keene, S. J., Miravitlles, M., Crisafulli, E., Torres, A., Mueller, C. E., Schüetz, P., Ringbæk, T., Fabbian, F., et al. (2024) · ERJ Open Research · doi:10.1183/23120541.00838-2023 · Cited by 62 · see citing works
Predictors of 30- and 90-Day COPD Exacerbation Readmission: A Prospective Cohort Study
Alqahtani, J. S., Aldabayan, Y. S., Aldhahir, A. M., Rajeh, A. M. A., Mandal, S., & Hurst, J. R. (2021) · International Journal of COPD · doi:10.2147/copd.s328030 · Cited by 54 · see citing works
Mapping the Global distribution, risk factors, and temporal trends of COPD incidence and mortality (1990–2021): ecological analysis
Naeem, S., Wang, F., Mubarak, R., Shen, H., Li, X., Mommers, I., Hussain, S. R., Malik, S. S., Yu, C., Hak, E., et al. (2025) · BMC Medicine · doi:10.1186/s12916-025-04014-0 · Cited by 46 · see citing works
“It’s important to note that these estimates may be conservative due to underdiagnoses of COPD in many cases [13, 14].”
Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey
Alqahtani, J. S., Mendes, R. G., Aldhahir, A. M., Rowley, D. D., AlAhmari, M. D., Ntoumenopoulos, G., Alghamdi, S. M., Sreedharan, J. K., Aldabayan, Y. S., Oyelade, T., et al. (2020) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s279031 · Cited by 39 · see citing works
A systematic review and meta-analysis of heart rate variability in COPD
Alqahtani, J. S., Aldhahir, A. M., Alghamdi, S. M., Ghamdi, S. S. A., AlDraiwiesh, I. A., Alsulayyim, A. S., Alqahtani, A., Alobaidi, N. Y., Saikhan, L. A., AlRabeeah, S. M., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1070327 · Cited by 36 · see citing works
Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Systematic Review
Chow, R., So, O. W., Im, J. H. B., Chapman, K. R., Orchanian‐Cheff, A., Gershon, A. S., & Wu, R. C. (2023) · International Journal of COPD · doi:10.2147/copd.s418295 · Cited by 42 · see citing works
Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary
Agustí, A. G. N., Celli, B. R., Criner, G. J., Halpin, D. M. G., Anzueto, A., Barnes, P. J., Bourbeau, J., Han, M. K., Martínez, F. J., de, M. M., et al. (2023) · Respirology · doi:10.1111/resp.14486 · Cited by 36 · see citing works
“78,79 In patients with COPD not due to smoking, there is insufﬁcient”
Incidence and Prognostic Factors of Respiratory Viral Infections in Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Jang, J. G., Ahn, J. H., & Jin, H. J. (2021) · International Journal of COPD · doi:10.2147/copd.s306916 · Cited by 32 · see citing works
“Recent study reported comorbidities (heart failure, renal failure, depression, and alcohol use), previous exacerbation and hospitalization, and longer duration of admission were associated with risk factors for readmission.(38) Although one study showed frequency of AECOPD is related to the frequency of the common col…”
Background
Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review
Alqahtani, J. S., Oyelade, T., Sreedharan, J. K., Aldhahir, A. M., Alghamdi, S., Rajeh, A. M. A., Alqahtani, A., Alsulayyim, A. S., Aldabayan, Y. S., Alobaidi, N. Y., et al. (2020) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2020-000717 · Cited by 31 · see citing works
Outpatient Follow-Up and 30-Day Readmissions
Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.41272 · Cited by 27 · see citing works
National clinical audit for hospitalised exacerbations of COPD
Hurst, J. R., Quint, J. K., Stone, R. A., Silove, Y., Youde, J., & Roberts, C. M. (2020) · ERJ Open Research · doi:10.1183/23120541.00208-2020 · Cited by 27 · see citing works
Pulmonary rehabilitation for COPD
Aldhahir, A. M., Alghamdi, S. M., Alqahtani, J. S., Alqahtani, K. A., Rajah, A. M. A., Alkhathlan, B. S., Singh, S. J., Mandal, S., & Hurst, J. R. (2021) · Annals of Thoracic Medicine · doi:10.4103/atm.atm_639_20 · Cited by 26 · see citing works
“They also have reduced exercise capacity and increased susceptibility to periodic chest infections or worsening of their symptoms, referred to as “exacerbations” that might lead to hospital admissions.[2]”
Background
Smoking cessation during COVID-19: the top to-do list
Alqahtani, J. S., Aldhahir, A. M., Oyelade, T., Alghamdi, S. M., & Almamary, A. S. (2021) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-021-00238-8 · Cited by 25 · see citing works
Mepolizumab for COPD with Eosinophilic Phenotype following Hospitalization
Flynn, C. A., McAuley, H. J. C., Elneima, O., Aung, H., Ibrahim, W., Ward, T., Bourne, M., Thornton, T. D., Mistry, V., Gilbert, H. R., et al. (2025) · NEJM Evidence · doi:10.1056/evidoa2500012 · Cited by 22 · see citing works
Management and Risk of Mortality in Patients Hospitalised Due to a First Severe COPD Exacerbation
Janson, C., Nwaru, B. I., Wiklund, F., Telg, G., & Ekström, M. P. (2020) · International Journal of COPD · doi:10.2147/copd.s276819 · Cited by 22 · see citing works
A systematic review and meta-analysis of chronic obstructive pulmonary disease in asia: risk factors for readmission and readmission rate
Lin, P. R., Shen, C., Li, Q., Huang, Y., Zhou, J., Lu, Y., He, A., Liu, X., & Luo, M. (2024) · BMC Pulmonary Medicine · doi:10.1186/s12890-024-03203-6 · Cited by 21 · see citing works
“Although understanding of the risk factors for COPD readmission has improved, existing investigations have primarily focused on populations in Europe and North America [4], while research targeting Asian populations is rare.”
BackgroundInfluential
Evaluation of step-down oral antibiotic therapy for uncomplicated streptococcal bloodstream infections on clinical outcomes
Kang, A. Y., Beuttler, R., & Minejima, E. (2022) · Therapeutic Advances in Infectious Disease · doi:10.1177/20499361211073248 · Cited by 20 · see citing works
High Blood Eosinophil and YKL-40 Levels, as Well as Low CXCL9 Levels, are Associated with Increased Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Peng, J., Yu, Q., Fan, S., Chen, X., Tang, R., Wang, D., & Qi, D. (2021) · International Journal of COPD · doi:10.2147/copd.s294968 · Cited by 20 · see citing works
All-cause readmission rate and risk factors of 30- and 90-day after discharge in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Ruan, H., Zhao, H., Wang, J., Zhang, H., & Li, J. (2023) · Therapeutic Advances in Respiratory Disease · doi:10.1177/17534666231202742 · Cited by 19 · see citing works
“22 reported some risk factors for all-cause COPD readmission, read-mission rate has not been pooled.”
BackgroundMethodResultInfluential
Factors Influencing the Length of Hospital Stay Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in Macao Population: A Retrospective Study of Inpatient Health Record
Li, M., Cheng, K., Ku, K., Li, J., Hu, H., & Ung, C. O. L. (2021) · International Journal of COPD · doi:10.2147/copd.s307164 · Cited by 18 · see citing works
All-cause admissions following a first ever exacerbation-related hospitalisation in COPD
Waeijen-Smit, K., Jacobsen, P. A., Houben‐Wilke, S., Simons, S. O., Franssen, F. M. E., Spruit, M. A., Pedersen, C. T., Kragholm, K. H., & Weinreich, U. M. (2022) · ERJ Open Research · doi:10.1183/23120541.00217-2022 · Cited by 18 · see citing works
Employment Status, Readmission and Mortality After Acute Exacerbation of COPD
Jacobsen, P. A., Kragholm, K. H., Torp-Pedersen, C. T., Janssen, D. J. A., Spruit, M. A., & Weinreich, U. M. (2021) · International Journal of COPD · doi:10.2147/copd.s319840 · Cited by 16 · see citing works
eHealth Program to Reduce Hospitalizations Due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Retrospective Study
van Buul, A. R., Derksen, C., Hoedemaker, O., van Dijk, O., Chavannes, N. H., & Kasteleyn, M. J. (2021) · JMIR Formative Research · doi:10.2196/24726 · Cited by 15 · see citing works
“However, especially for the patient group that is at risk of hospitalizations [32], there is a need for intensive support to prevent future hospitalizations.”
Background
Key toolkits of non-pharmacological management in COPD: during and beyond COVID-19
Alqahtani, J. S., Alghamdi, S. M., Aldhahir, A. M., Althobiani, M. A., & Oyelade, T. (2021) · Frontiers in Bioscience-Landmark · doi:10.52586/4938 · Cited by 15 · see citing works
Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study
Aldhahir, A. M., Alqahtani, J. S., Alghamdi, S. M., Alqarni, A. A., Khormi, S. K., Alwafi, H. H., Samannodi, M. S., Siraj, R. A., Alhotye, M., Naser, A. Y., et al. (2022) · Healthcare · doi:10.3390/healthcare10050904 · Cited by 15 · see citing works
“worsening of these symptoms, referred to as ‘exacerbations’ in patients with COPD, is associated with reduced exercise capacity and increased susceptibility to frequent chest infections that might lead to hospital admissions [2].”
Background
Factors affecting length of hospital stay in chronic obstructive pulmonary disease patients in a tertiary hospital of Nepal: A retrospective cross-sectional study
Pokharel, P., Lamichhane, P., Pant, P., & Shrestha, A. B. (2022) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2022.104246 · Cited by 14 · see citing works
Predicting COPD Readmission: An Intelligent Clinical Decision Support System
López-Canay, J., Casal-Guisande, M., Pinheira, A. G., Golpe, R., Comesaña-Campos, A., Fernández-García, A., Represas‐Represas, C., & Fernández‐Villar, A. (2025) · Diagnostics · doi:10.3390/diagnostics15030318 · Cited by 14 · see citing works
Home parasternal electromyography tracks patient-reported and physiological measures of recovery from severe COPD exacerbation
D'Cruz, R. F., Suh, E., Kaltsakas, G., Dewar, A., Shah, N. M., Priori, R., Douiri, A., Rose, L., Hart, N., & Murphy, P. B. (2021) · ERJ Open Research · doi:10.1183/23120541.00709-2020 · Cited by 14 · see citing works
“Reasons for 30-day readmissions are multifactorial, with risk factors including annual exacerbation frequency, comorbidities and hospital length of stay [15, 16], We propose that reported reductions in readmission risk immediately post-discharge are partially attributable to physiological recovery, involving improved…”
Background
Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions
Kozioł, M., Towpik, I., Żurek, M., Niemczynowicz, J., Wasążnik, M., Sanchak, Y., Wierzba, W., Franek, E., & Walicka, M. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10245814 · Cited by 14 · see citing works
Predictors of short-term COPD readmission
Quintana, J. M., Antón-Ladislao, A., Orive, M., Arámburu, A., Iriberri, M., Sánchez, R. G., Jiménez-Puente, A., de Miguel‐Díez, J., Esteban, C., & the ReEPOC-REDISSEC group (2022) · Internal and Emergency Medicine · doi:10.1007/s11739-022-02948-4 · Cited by 14 · see citing works
“For all these reasons, readmissions by COPD is considered a marker of quality of care [2, 3].”
BackgroundMethod
COPD in Africa: risk factors, hospitalisation, readmission and associated outcomes—a systematic review and meta-analysis
Njoku, C. M., Hurst, J. R., Kinsman, L., Balogun, S. A., & Obamiro, K. O. (2023) · Thorax · doi:10.1136/thorax-2022-218675 · Cited by 13 · see citing works
The Impact of a Home Respiratory Therapist to Reduce 30-Day Readmission Rates for Exacerbation of COPD
Truumees, M., Kendra, M., Tonzola, D., Chiu, S. H., Cerrone, F., Zimmerman, D., Mackwell, C., Stevens, C., Scannell, K., Daley, B., et al. (2022) · Respiratory Care · doi:10.4187/respcare.08125 · Cited by 13 · see citing works
Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study
Aldhahir, A. M., Alqahtani, J. S., AlDraiwiesh, I. A., Alghamdi, S. M., Alsulayyim, A. S., Alqarni, A. A., Alhotye, M., Alwafi, H. H., Siraj, R. A., Rajeh, A. M. A., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-063900 · Cited by 12 · see citing works
Endobronchial lung volume reduction with valves reduces exacerbations in severe emphysema patients
Brock, J. M., Böhmker, F., Schuster, P. U., Eberhardt, R., Gompelmann, D., Kontogianni, K., Dittrich, S. A., Benjamin, N., & Herth, F. J. F. (2023) · Respiratory Medicine · doi:10.1016/j.rmed.2023.107399 · Cited by 12 · see citing works
Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review
Soytaş, R. B., Levinoff, E. J., Smith, L., Döventaş, A., Morais, J., Veronese, N., & Soysal, P. (2023) · Epidemiologia · doi:10.3390/epidemiologia4040035 · Cited by 12 · see citing works
“In a systematic review in 2020 that identiﬁed risk factors for rehospitalization following a COPD exacerbation, the rehospitalization rate at 30 days after hospitalization for COPD exacerbation was found to be between 9% and 26%, and at 90 days between 18% and 39% [90].”
Background
Reducing Hospital Readmissions in Chronic Obstructive Pulmonary Disease Patients: Current Treatments and Preventive Strategies
di Chiara, C., Sartori, G., Fantin, A., Castaldo, N., & Crisafulli, E. (2025) · Medicina · doi:10.3390/medicina61010097 · Cited by 12 · see citing works
“In the US, around 19% of COPD patients are readmitted within 30 days, while in the UK, the rates are about 24% within 30 days and 43% within 90 days of discharge [10].”
Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study
Vogelmeier, C. F., Friedrich, F. W., Timpel, P., Kossack, N., Diesing, J., Pignot, M., Abram, M., Gediga, M., & Halbach, M. (2025) · International Journal of COPD · doi:10.2147/copd.s488701 · Cited by 11 · see citing works
Fate or coincidence: do COPD and major depression share genetic risk factors?
Martucci, V. L., Richmond, B. W., Davis, L. K., Blackwell, T. S., Cox, N. J., Samuels, D. C., Edwards, D. R. V., & Aldrich, M. C. (2021) · Human Molecular Genetics · doi:10.1093/hmg/ddab068 · Cited by 12 · see citing works
Strategies to Prevent Readmissions to Hospital for COPD: A Systematic Review
Sharpe, I., Bowman, M., Kim, A., Srivastava, S., Jalink, M., & Wijeratne, D. T. (2021) · COPD · doi:10.1080/15412555.2021.1955338 · Cited by 13 · see citing works
“As such, these types of interventions may be useful in addressing the modifiable risk factors for readmission, which include smoking status, alcohol use, and underweight (all-cause readmissions), as well as malnutrition (COPD-related readmissions) [2, 3].”
Background
Advances in chronic obstructive pulmonary disease: management of exacerbations
Jeyachandran, V., & Hurst, J. R. (2022) · British Journal of Hospital Medicine · doi:10.12968/hmed.2022.0275 · Cited by 10 · see citing works
Risk Factors of Readmission Within 90 Days for Chronic Obstructive Pulmonary Disease Patients with Frailty and Construction of an Early Warning Model
Li, J., Ma, X., Zeng, X., Chen, Z., & Zhu, T. (2023) · International Journal of COPD · doi:10.2147/copd.s400638 · Cited by 10 · see citing works
“5– 39%.(8,9) Moreover, the in-hospital mortality is higher in COPD patients readmitted within 90 d than in those not (13.”
Background
Chronic Obstructive Pulmonary Disease and the Management of Cardiopulmonary Risk in the UK: A Systematic Literature Review and Modified Delphi Study
Shrikrishna, D., Steer, J., Bostock, B., Dickinson, S., Piwko, A., Ramalingam, S., Saggu, R., Stonham, C., Storey, R. F., Taylor, C. J., et al. (2025) · International Journal of COPD · doi:10.2147/copd.s523865 · Cited by 9 · see citing works
Secular trend and risk factors of 30-day COPD-related readmission in Beijing, China
Li, J., Liang, L., Cao, S., Rong, H.-M., Feng, L., Zhang, D., Chu, S., Jing, H., & Tong, Z. (2022) · Scientific Reports · doi:10.1038/s41598-022-20884-3 · Cited by 9 · see citing works
Global initiative for chronic obstructive lung disease 2023 report: gold executive summary
Agustí, A. G. N., Celli, B. R., Criner, G. J., Halpin, D. M. G., Anzueto, A., Barnes, P. J., Bourbeau, J., Han, M. K., Martínez, F. J., de, M. M., et al. (2023) · Journal of the Pan African Thoracic Society · doi:10.25259/jpats_ges_2023 · Cited by 10 · see citing works
Identifying risk prediction models and predictors for hospital readmission in patients with medical conditions: A systematic review and meta-analysis
Selmer, N. W., Berthelsen, C. B., Grootven, B. V., Meyer, G., & Loft, M. I. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105188 · Cited by 8 · see citing works
Predicting mortality after hospitalisation for COPD using electronic health records
Pellicori, P., McConnachie, A., Carlin, C. M., Wales, A., & Cleland, J. G. F. (2022) · Pharmacological Research · doi:10.1016/j.phrs.2022.106199 · Cited by 8 · see citing works
“Recurrent admissions are common and subsequent mortality substantial [2 – 4].”
Background
Readmission Risk after COVID-19 Hospitalization: A Moderation Analysis by Vital Signs
Finn, A., Tanzer, J. R., Jindal, A., Selvaraj, V., Collins, B., & Dapaah-Afriyie, K. (2022) · Southern Medical Journal · doi:10.14423/smj.0000000000001472 · Cited by 8 · see citing works
“Comorbid conditions also have strong associations with readmission in other conditions requiring hospitalization, including influenza, congestive heart failure, and chronic obstructive pulmonary disease.(14,24,25) Our analysis is broadly consistent with findings from other reports that underlying pulmonary and cardiac…”
Result
Review of Prediction Analytics Studies on Readmission for the Chronic Conditions of CHF and COPD: Utilizing the PRISMA Method
Ben‐Assuli, O. (2021) · Information Systems Management · doi:10.1080/10580530.2021.1928341 · Cited by 8 · see citing works
“Typically, only one diagnosis is considered in review articles (e.g., heart failure (Mahajan et al., 2018), kidney injury (Zhao & Chen, 2020), liver resection (Zhao et al., 2017) and COPD (Alqahtani et al., 2020)).”
Background
The Association with COPD Readmission Rate and Access to Medical Institutions in Elderly Patients
Kim, T. W., Choi, E. S., Kim, W. J., & Jo, H. S. (2021) · International Journal of COPD · doi:10.2147/copd.s302631 · Cited by 8 · see citing works
Characteristics of 12-Month Readmission for Hospitalized Patients with COPD: A Propensity Score Matched Analysis of Prospective Multicenter Study
Xu, T., Sun, W., Zhao, H., Wang, X., Yuan, Q., Zhang, X., Mao, S., Zhang, X., Zhao, M., Sheng, Z., et al. (2022) · International Journal of COPD · doi:10.2147/copd.s376909 · Cited by 7 · see citing works
“Furthermore, studies mostly focused on short-term readmission such as 30 days or 90 days after discharge.(11,12) Several studies have explored rates and risk factors related to readmission within 12 months, most were retrospective studies.”
Background
Disease burden and health-related outcomes of patients discharged from hospital following a COPD exacerbation in the United States
Bhutani, M., Müllerová, H., Patel, D., Barjaktarević, I., Loke, W. J., Pollack, M. F., Roberts, M. H., Tamondong-Lachica, D. R., Tang, F., & Celli, B. R. (2025) · Respiratory Medicine · doi:10.1016/j.rmed.2025.108337 · Cited by 7 · see citing works
COPD and Depression Analysis in Regard to Obstructive Pulmonary Levels
Jelić, I., Mihajlović, G., Mihajlović, F., Minić, N., Ratinac, M., & Pantović-Stefanović, M. (2023) · Healthcare · doi:10.3390/healthcare11081175 · Cited by 7 · see citing works
“Our study included patients below 50 years, correlating with [4] and [19].”
Background
Recent functional decline and outpatient follow-up after hospital discharge: a cohort study
Bogler, O., Kirkwood, D. H., Austin, P. C., Jones, A., Sinn, C. J., Okrainec, K., Costa, A. P., & Lapointe‐Shaw, L. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04192-7 · Cited by 7 · see citing works
“The evidence supporting the benefit of early physician follow-up for preventing read-missions is strongest for patients with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF), where rates of readmission post-hospital-ization are high [20, 24–30].”
Background
30-Day Readmission Rate of Patients with COPD and Its Associated Factors: A Retrospective Cohort Study from a Tertiary Care Hospital
Kee, Y. S., Wong, C. K., Aziz, M. A. A., Zakaria, M. I., Shaarif, F. M., Ng, K. S., Liam, C. K., Pang, Y. K., & Khoo, E. M. (2023) · International Journal of COPD · doi:10.2147/copd.s429108 · Cited by 7 · see citing works
“…findings showed a higher baseline mMRC grading is statistically associated with 30-day readmission, but it was not significant in Alqahtani et al. 22 The reason behind was Alqahtani et al looked at the patients’ mMRC grading on admission and before discharge, which usually will be higher as…”
Background
New insights into the pathophysiology and epidemiology of COPD exacerbations
Finney, L., MacLeod, M. A., & Wedzicha, J. A. (2024) · European Respiratory Society eBooks · doi:10.1183/2312508x.10007923 · Cited by 7 · see citing works
Unmet need in the management of chronic obstructive pulmonary disease in the Middle East and Africa region: An expert panel consensus
Al-Moamary, M. S., Köktürk, N., Idrees, M. M., Şen, E., Juvelekian, G. S., Saleh, W. A., Zoumot, Z., Behbehani, N., Hatem, A., Masoud, H. H., et al. (2021) · Respiratory Medicine · doi:10.1016/j.rmed.2021.106641 · Cited by 7 · see citing works
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S118 Risk factors for all-cause COPD readmission: a systematic review and meta-analysis
Alqahtani, J. S., Njoku, C. M., Bereznicki, B. J., Wimmer, B. C., Peterson, G. M., Kinsman, L., Aldabayan, Y. S., Rajeh, A. M. A., Aldhahir, A. M., Mandal, S., et al. (2019) · doi:10.1136/thorax-2019-btsabstracts2019.124
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Readmission rates within the first 30 and 90 days after severe COPD exacerbations (RACE study)
Baydar, O., Polatlı, M., Baha, A., Köktürk, N., Yapar, D., Ozkan, S., Şen, E., Çiftçi, F., Ozturk, B., Cengiz, S. K., et al. (2024) · Medicine · doi:10.1097/md.0000000000040483 · Cited by 3 · see citing works
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Authors: Alqahtani, J. S., Njoku, C. M., Bereznicki, B., Wimmer, B. C., Peterson, G. M., Kinsman, L., Aldabayan, Y. S., Alrajeh, A. M., Aldhahir, A. M., Mandal, S., & Hurst, J. R.
Affiliations: Prince Sultan Military College of Health Sciences (SA)
University of Tasmania (AU)
University of Newcastle Australia (AU)
University College London (GB)
Royal Free London NHS Foundation Trust (GB)
Corresponding author: Alqahtani, Jaber S.
ORCID: Alqahtani, Jaber S.
Njoku, Chidiamara M.
Bereznicki, Bonnie
Wimmer, Barbara C.
Peterson, Gregory M.
Kinsman, Leigh
Aldabayan, Yousef S.
Alrajeh, Ahmed M.
Aldhahir, Abdulelah M.
Mandal, Swapna
Hurst, John R.
Venue: European Respiratory Review
Publisher: European Respiratory Society (ERS)
Published: 2020-06-03
Volume: 29
Issue: 156
Pages: 190166
ISSN: 0905-9180 (ISSN-L)
1600-0617
DOI: 10.1183/16000617.0166-2019
PMC: PMC9488450
OpenAlex: W3033975634
Cited by: 149
References: 57
Citations by year: 2026: 19 · 2025: 19 · 2024: 16 · 2023: 34 · 2022: 26 · 2021: 28 · 2020: 7
FWCI: 3.33
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0/ (vor)
Locations: European Respiratory Review (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
UTAS Research Repository (acceptedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
UCL Discovery (University College London) (submittedVersion)
Figshare (submittedVersion, cc-by-nc)
NOVA (University of Newcastle Australia) (submittedVersion, cc-by-nc)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
Keywords: COPD exacerbations, hospital readmission, all-cause readmission, risk factors, comorbidities, heart failure, renal failure, depression, alcohol consumption, length of hospital stay, sex differences
MeSH terms: Adult, Aged, Aged, 80 and over, Female, Humans, Length of Stay, Male, Middle Aged, Patient Readmission, Prognosis, Risk Factors, Time Factors, Comorbidity, Disease Progression, Risk Assessment, Pulmonary Disease, Chronic Obstructive

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Risk factors for all-cause hospital readmission following exacerbation of COPD: A systematic review and meta-analysis

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