Study on factors influencing recrudescent time of postdischarge patients
with chronic obstructive pulmonary disease
Lan Wang, Xiao-Ying Zang, Qing Zhang, Su-Yan Liu, Yue-Hao Shen and Yue Zhao
Aim. (1) To explore the prognostic factors of patients with chronic obstructive pulmonary disease. (2) To calculate the
recrudescence time (the time from discharge to acute exacerbation again) of postdischarge patients with chronic obstructive
pulmonary disease.
Background. Chronic obstructive pulmonary disease is an airflow limitation illness that is preventable and treatable. To find out
the prognostic factors will make effective postdischarge care, which can help patients reduce readmission times and prolong
recrudescent time.
Design. Cohort study.
Method. From November 2007–October 2008, 136 patients with acute exacerbation of chronic obstructive pulmonary disease
were analysed by gender, age, career, education level, body mass index, smoking, oxygen therapy, drug-taken compliance,
respiratory function exercise, blood gas, lung function, six-minute walking test and degree of dyspnoea. Factors related to
prognosis were analysed by univariate and multivariate Cox regression. Kaplan–Meier method was used for survival analysis
and log-rank test for comparison of survival curve.
Results. A total of 121 patients recrudesced up to October 2009. Recrudescence rate was 7Æ35% in a month, 25Æ00% in three
months, 55Æ62% in six months and 88Æ23% in 12 months. Higher drug-taken compliance and respiratory function exercise
were the factors influencing patients’ acute exacerbation (p < 0Æ05). The median recrudescence time of drug taken or not was
six and four months, and doing respiratory function exercise or not was eight and six months.
Conclusion. Respiratory function exercise and higher drug-taken compliance can prolong recrudescence time and reduce
recrudescence rate.
Relevance to clinical practice. Clinical nurses who know more risk factors about acute exacerbation of patients with chronic
obstructive pulmonary disease can provide effective discharge planning, which will increase patients’ quality of life and decrease
mortality.