BACKGROUND Pulmonary diseases are a common and costly cause of 30-day readmissions. Few studies have focused on the difference in risk for rehospitalization between men and women in older patients. In this study we analyzed the association between sex and the risk of readmission in a cohort of patients admitted to the hospital for chronic obstructive pulmonary disease (COPD) exacerbation and other major pulmonary diseases. METHODS This was a retrospective cohort study based on administrative data collected in the Veneto Region in 2016. We included 14,869 hospital admissions among residents aged ≥65 years for diagnosis related groups (DRGs) of the most common disorders of the respiratory system: bronchitis and asthma, pneumonia, pulmonary edema, respiratory failure, and COPD. Multilevel logistic regressions were performed to test the association between 30-day hospital readmission and sex, adjusting for confounding factors. RESULTS For bronchitis and asthma, male patients had significantly higher odds of 30-day readmission than female patients (adjusted odds ratio (aOR), 2.07; 95% confidence interval (CI), 1.11-3.87). The odds of readmission for men were also significantly higher for pneumonia (aOR, 1.40; 95% CI, 1.13-1.72), for pulmonary edema and respiratory failure (aOR, 1.28; 95% CI, 1.05-1.55), and for COPD (aOR, 1.34; 95% CI, 1.00-1.81). CONCLUSIONS This study found that male sex is a major risk factors for readmission in patients aged more than 65 years with a primary pulmonary diagnosis. More studies are needed to understand the underlying determinants of this phenomena and to provide targets for future interventions.

中文翻译：

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性别作为因肺部疾病而再次入院的危险因素的重要性。

背景技术肺部疾病是30天再次入院的常见且代价高昂的原因。很少有研究关注老年患者中男性和女性再次住院风险的差异。在这项研究中，我们分析了因慢性阻塞性肺疾病（COPD）加重和其他主要肺部疾病住院的患者队列中性别与再次入院风险之间的关联。方法这是一项基于2016年威尼托大区行政数据收集的回顾性队列研究。我们纳入了≥65岁居民中14,869例入院患者，这些患者是呼吸系统最常见疾病的诊断相关组（DRG）：支气管炎和哮喘，肺炎，肺水肿，呼吸衰竭和COPD。进行多级logistic回归以检验30天医院再次入院与性别之间的关联，并调整混杂因素。结果对于支气管炎和哮喘，男性患者30天再入院的机率明显高于女性患者（调整后的优势比（aOR）为2.07； 95％的置信区间（CI）为1.11-3.87）。男性肺炎（aOR，1.40; 95％CI，1.13-1.72），肺水肿和呼吸衰竭（aOR，1.28; 95％CI，1.05-1.55）和COPD的男性再次入院的机率也明显更高（ aOR，1.34； 95％CI，1.00-1.81）。结论本研究发现，男性是65岁以上初次肺部诊断的患者再次入院的主要危险因素。