According to a study published in The Journal of Allergy and Clinical Immunology: In Practice, comorbid chronic rhinitis is significantly associated with 30-day hospital readmissions related to asthma and chronic obstructive pulmonary disease (COPD).
Investigators of this retrospective cohort study sought to identify which comorbid conditions could potentially trigger acute exacerbations of asthma and COPD in order to prevent early hospital readmissions. Furthermore, the investigators evaluated the specific association of chronic rhinitis with 30-day asthma and COPD hospital readmissions.
Data were extracted from asthma- and COPD-related hospital encounters that took place at the University of Cincinnati Hospitals between June 15, 2012 and July 19, 2017. Analysis was performed on 4754 patients with a primary discharge diagnosis of asthma and 2176 patients with COPD and identified patients’ demographic information, pre-existing comorbidities, medication use, and relevant clinical parameters reported upon admission.
A total of 858 of 4768 patients with asthma and 405 of 2176 patients with COPD were readmitted to the hospital ≥1 within 30 days after initial discharge. This comprised 16.5% of all asthma-related and 15.5% of all COPD-related hospital encounters. Comorbidities that independently determined a significant risk for 30-day hospital readmissions related to asthma and COPD included allergic and nonallergic rhinitis, arrhythmia, diabetes, hypertension, obesity, and tobacco use. The number of previous readmissions was also an independent determinant of risk.
The frequency of early readmissions for asthma and COPD was significantly higher in patients with comorbid chronic allergic rhinitis (hazard ratio [HR], 4.4; 95% CI, 3.9-5.0 and HR, 2.4; 95% CI, 1.7-3.2, respectively; both P <.0001) or nonallergic rhinitis (HR 3.7; 95% CI, 2.9-4.9 and HR 2.6; 95% CI, 1.8-3.7, respectively; both P <.0001)) than patients without rhinitis.
Limitations of the study included using data from a single hospital system, which may not be generalizable to other healthcare systems in different regions, and potential misdiagnosis of comorbid conditions due to unmatched diagnosis codes. Quality of hospital care was not assessed, nor were factors indicating general health, disease severity, socioeconomic factors, or mental illness, all which could have affected readmission rates.
Study findings showed that 30-day readmission risk related to asthma and COPD was significantly higher in patients with comorbid chronic rhinitis. Proper diagnosis of chronic rhinitis in patients with asthma and COPD can prompt management of rhinitis symptoms to reduce early readmissions and alleviate associated healthcare burden.
Reference
Singh U, Wangia-Anderson V, Bernstein JA. Chronic rhinitis is a high-risk comorbidity for 30-day re-admission of patients with asthma and chronic obstructive pulmonary disease [published online July 25, 2018]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2018.06.029
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