Chest
Original Research: COPDAssociation of Psychological Disorders With 30-Day Readmission Rates in Patients With COPD
Section snippets
Data Source
This study used files from the 5% Medicare sample from 2001 to 2011 provided by Research Data Assistance Center (ResDAC).23 The CMS select a random sample of 5% Medicare beneficiaries based on the eighth and ninth digits (05, 20, 45, 70, and 95) of their health insurance claim number; this is the standard dataset available for research purposes and has been shown to be representative of the whole cohort. The study was approved by the University of Texas Medical Branch institutional review board
Results
Between 2001 and 2011, 135,498 hospitalizations occurred for COPD in 80,088 fee-for-service Medicare patients. Of these, 30,218 (22.30%) patients had one or more coexisting psychological disorders, with highest prevalence in most recent years, as noted in earlier studies.31, 32 Table 1 shows the baseline characteristics of the cohort stratified according to presence of these psychological disorders. Relative to patients with COPD without coexisting psychological disorders, patients with these
Discussion
In this retrospective cohort study, we found that psychological disorders such as depression, anxiety, psychosis, alcohol abuse, and drug abuse contribute significantly to the 30-day readmission rate for elderly patients with COPD. Similar to prior studies, we found that patients with COPD with low socioeconomic status,33, 34 psychosis,35 and alcohol abuse36 had higher readmission rates. This is likely related to limited capacity of these patients to meet the workload of disease burden, poor
Acknowledgments
Author contributions: G. Singh had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis, including and especially any adverse effects. G. Singh served as principal author. W. Z., Y.-F. K., and G. Sharma contributed to the conception, study design, analysis, interpretation of results, drafting of manuscript, and final approval of the manuscript.
Financial/nonfinancial disclosures: G. Sharma served on the advisory
References (73)
- et al.
Surprisingly high prevalence of anxiety and depression in chronic breathing disorders
Chest
(2005) - et al.
Bidirectional associations between clinically relevant depression or anxiety and COPD: a systematic review and meta-analysis
Chest
(2013) - et al.
Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion
Chest
(2015) - et al.
Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries
Respir Med
(2006) - et al.
Prevalence of depressive symptoms and predictors of treatment among U.S. adults from 2005 to 2010
Gen Hosp Psychiatry
(2014) - et al.
Prevalence and correlates of major depressive disorder and dysthymia in an eleven-year follow-up: results from the Finnish Health 2011 Survey
J Affect Disord
(2015) - et al.
Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality
Psychosomatics
(2011) - et al.
Short- and medium-term prognosis in patients hospitalized for COPD exacerbation: the CODEX index
Chest
(2014) - et al.
Temporal trends in hospitalization rates for older adults with chronic obstructive pulmonary disease
Am J Med
(2013) - et al.
Predictors of rehospitalization and death after a severe exacerbation of COPD
Chest
(2007)
Mental disorders in chronic obstructive pulmonary disease (COPD)
Respir Med
Anxiety and depression in COPD: current understanding, unanswered questions, and research needs
Chest
Depression and smoking amongst older general practice patients
J Affect Disord
The catastrophic misinterpretation of physiological distress
Behav Res Ther
The association between alcohol consumption and risk of COPD exacerbation in a veteran population
Chest
Improvement in mood, physical symptoms, and function with nortriptyline for depression in patients with chronic obstructive pulmonary disease
Psychosomatics
Outcomes of depressed patients undergoing inpatient pulmonary rehabilitation
Am J Geriatr Psychiatry
The impact of anxiety and depression on outcomes of pulmonary rehabilitation in patients with COPD
Chest
Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis
J Psychosom Res
A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease
Arch Phys Med Rehabil
Predicting the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization
Am Heart J
The validity of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for identifying patients hospitalized for COPD exacerbations
Chest
Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life
Arch Intern Med
Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease
Arch Intern Med
Mood disorders in elderly patients with chronic obstructive pulmonary disease
Rev Clin Gerontol
Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review
Nord J Psychiatry
Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles
Int J Geriatr Psychiatry
Chronic obstructive pulmonary disease patients with psychiatric disorders are at greater risk of exacerbations
Psychosom Med
Clinical and economic burden of depression/anxiety in chronic obstructive pulmonary disease patients within a managed care population
COPD
Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations
Am J Respir Crit Care Med
The association between depressive symptoms and acute exacerbations of COPD
Lung
Effects of depression diagnosis and antidepressant treatment on mortality in Medicare beneficiaries with chronic obstructive pulmonary disease
J Am Geriatr Soc
Rehospitalizations among patients in the Medicare fee-for-service program
N Engl J Med
Susceptibility to exacerbation in chronic obstructive pulmonary disease
N Engl J Med
Risk assessment of readmissions following an initial COPD-related hospitalization
Int J Chron Obstruct Pulmon Dis
Cited by (0)
FUNDING/SUPPORT: This work was supported by the Agency for Healthcare Research and Quality [Grant R01-HS020642], the Patient-Centered Outcomes Research Institute [Grant R24HS022134], the Clinical and Translational Science Award [Grant UL1TR000071] from the National Center for Advancing Translational Sciences, and the Claude D. Pepper Older Americans Independence Center [Grant 5P30-AG024832].