PMID: 15338797Sep 2, 2004Paper

Paradoxical results in the study of risk factors of chronic obstructive pulmonary disease (COPD) re-admission

Respiratory Medicine
J Garcia-AymerichEFRAM Investigators

Abstract

We have previously reported an apparently paradoxical association between medical care related factors and an increased risk of chronic obstructive pulmonary disease (COPD) re-hospitalisation, in a cohort of 346 COPD subjects from Barcelona, Spain. Confounding by severity or by indication is a plausible explanation. We tested the confounding effect of severity-related variables on these paradoxical associations. Forced expiratory volume in one second (FEV1), arterial oxygen pressure (PO2) and previous COPD admissions were associated with: (1) the presence of medical care related factors, and (2) re-admission during follow-up. Risks of readmission associated with most of the medical care related factors were reduced after adjustment for the severity variables. The risk associated with long-term oxygen therapy use changed from a crude OR of 2.36 (95% CI: 1.79-3.11) to an adjusted OR of 1.38 (0.95-2.00), while that associated with anticholinergics use varied from 3.52 (2.37-5.21) to 2.10 (1.32-3.36)). We concluded that the excess risk of COPD re-admission associated with medical care related factors might be partially due to confounding by indication. Residual confounding may still account for part of the remaining excess risk. Tr...Continue Reading

References

Feb 1, 1987·Annals of Internal Medicine·N R AnthonisenN A Nelson
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Jun 12, 1999·Journal of the American Geriatrics Society·B M PsatyC D Furberg
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Jan 30, 2003·Thorax·J Garcia-AymerichUNKNOWN Estudi del Factors de Risc d'Agudització de la MPOC investigators

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Citations

Jan 28, 2006·American Journal of Respiratory and Critical Care Medicine·David M ManninoKourtney J Davis
Jun 18, 2008·Journal of Pediatric Endocrinology & Metabolism : JPEM·Kazim SheikhStephen D Ketner

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