Evidence map›Paper›PMID 26801463›Full record

ArticleBMJ open2016

Patient characteristics associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (COPD) following primary care COPD diagnosis: a cohort study using linked electronic patient records.

L C Hunter, R J Lee, I Butcher, C J Weir, C M Fischbacher, D McAllister, S H Wild, N Hewitt, R M Hardie

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Predictors of Acute Exacerbations in COPD: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2026
    Pooled it
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  4. Article
  5. Observational
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  9. Review
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  12. Association of demographic variables and smoking habits with the severity of lung function in adult smokers.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022
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  19. Observational
  20. Management and Risk of Mortality in Patients Hospitalised Due to a First Severe COPD Exacerbation.International journal of chronic obstructive pulmonary disease · 2020
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

L C HunterDepartment of Public Health and Health Policy, NHS Lothian, Edinburgh, Midlothian, UK.
R J LeeCentre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh, Midlothian, UK.
I ButcherCentre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh, Midlothian, UK.
C J WeirReader in Medical Statistics and Associate Director (Statistics) Health Services Research Unit, Centre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh, Midlothian, UK.
C M FischbacherClinical Director for Information Services, Information Services Division (ISD), NHS National Services Scotland, Edinburgh, Midlothian, UK.
D McAllisterUsher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, Midlothian, UK.
S H WildUsher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, Midlothian, UK.
N HewittClinical Lead, Lothian Respiratory Managed Clinical Network, NHS Lothian, Edinburgh, Midlothian, UK.
R M HardieDepartment of Public Health and Health Policy, NHS Lothian, Edinburgh, Midlothian, UK.

Funding

Chief Scientist Office CZG/2/553
6 · The paper itself

Abstract

objectivesTo investigate patient characteristics of an unselected primary care population associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

designRetrospective open cohort using pseudonymised electronic primary care data linked to secondary care data.

settingPrimary care; Lothian (population approximately 800,000), Scotland.

participantsData from 7002 patients from 72 general practices with a COPD diagnosis date between 2000 and 2008 recorded in their primary care record. Patients were followed up until 2010, death or they left a participating practice.

main outcome measuresFirst and subsequent admissions for AECOPD (International Classification of Diseases (ICD) 10 codes J44.0, J44.1 in any diagnostic position) after COPD diagnosis in primary care.

results1756 (25%) patients had at least 1 AECOPD admission; 794 (11%) had at least 1 readmission and the risk of readmission increased with each admission. Older age at diagnosis, more severe COPD, low body mass index (BMI), current smoking, increasing deprivation, COPD admissions and interventions for COPD prior to diagnosis in primary care, and comorbidities were associated with higher risk of first AECOPD admission in an adjusted Cox proportional hazards regression model. More severe COPD and COPD admission prior to primary care diagnosis were associated with increased risk of AECOPD readmission in an adjusted Prentice-Williams-Peterson model. High BMI was associated with a lower risk of first AECOPD admission and readmission.

conclusionsSeveral patient characteristics were associated with first AECOPD admission in a primary care cohort of people with COPD but fewer were associated with readmission. Prompt diagnosis in primary care may reduce the risk of AECOPD admission and readmission. The study highlights the important role of primary care in preventing or delaying a first AECOPD admission.

Indexed as

Patient AdmissionPatient ReadmissionPrimary Health CareAge FactorsBody Mass IndexDisease ProgressionElectronic Health RecordsFemaleHumansMalePulmonary Disease, Chronic ObstructiveRetrospective StudiesRisk FactorsSeverity of Illness IndexSex FactorsSmokingPRIMARY CARE

Identifiers

PMID26801463
PMCPMC4735181

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.