Employment Status, Readmission and Mortality After Acute Exacerbation of COPD.

Abstract

IntroductionThe understanding of whether and to what extent employment status affects readmission and mortality is limited in patients with COPD.AimTo explore how employment status affects readmission and mortality after first admission to the hospital with acute exacerbation of COPD (AECOPD).MethodsThis study used Danish national registry-based data. All patients admitted for the first time to the hospital between 1999 and 2014 with a diagnosis of AECOPD, age 35–59, without a previous asthma diagnosis were included in the study. Employment status effect on 30-, 90-, and 365-day readmission and mortality was examined using logistic regression, adjusting for relevant confounders.ResultsA total of 11,850 COPD patients were included in the study of which 3563 (30%) were working, 1368 (12%) unemployed, 840 (7%) on sick leave, and 6079 (51%) receiving early retirement. Patients receiving early retirement had, compared to patients working, an adjusted increased likelihood of readmission at 30, 90, and 365 days (odds ratio (OR) 1.26 (CI95% (1.06–1.49)), 1.33 (CI95% (1.16–1.53)), and 1.48 (CI95% (1.33–1.66)), respectively). An increased likelihood was also seen in unemployed at 365 days follow-up (OR 1.44 (CI95% (1.22–1.68))). Early retirement was associated with an increased mortality at 30, 90, and 365 days (OR 1.39 (CI95% (1.07–1.80)) 1.37 (CI95% (1.09–1.79)) and 1.48 (CI95% (1.25–1.75)), respectively). An increased likelihood was also seen in patients receiving sick leave (OR 1.57 (CI95% (1.21–2.04))).ConclusionPatients with COPD who are not working at the time of first admission have a higher likelihood of readmission and mortality.