STRATIFICATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS BY PREVIOUS HOSPITAL ADMISSIONS AS A PREDICTOR FOR RISK OF FUTURE ADMISSION

C Bryden¹, W Bird¹, D Halpin², M Levy³

¹ Met Office

FitzRoy Road

Exeter EX1 3PB

² Royal Devon & Exeter Foundation Trust

Barrack Road

Exeter  EX2 5DW

³ University of Edinburgh

20 West Richmond Street

Edinburgh   EH8 9DX

This England-based study aims to identify when COPD patients are most at risk of admission to hospital, as part of a COPD health forecasting project.

COPD admissions data for 1997-2003 were divided into NIL, MOD or FRQ according to the number of admissions during the year prior to 1 Nov. During winter (Nov-Mar), each patient admitted was stratified into these groups and each week classified as “average”, “above average”, “high”, or “very high” risk.

NIL patients made up 68% of all winter admissions compared with 23% for MOD and 9% for FRQ patients. As admission rates increased from Average to Very High, admissions of NIL patients increased by 204% compared with 51% and 14% for MOD and FRQ patients respectively. FRQ patients who were admitted during winter had 2.0 admissions on average, compared with 1.3 for MOD and 1.1 for NIL patients.

Over two-thirds of patients admitted during winter had no admission during the previous 12 months. These patients account for over 90% of variation in admissions between “average” and “very high” weeks. Although patients with more previous admissions have a higher risk of admission in the winter, to manage peak COPD admissions NIL risk patients must be targeted.

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