{"id":"https://openalex.org/W7221464124","doi":"https://doi.org/10.7759/cureus.117762","title":"Predictors of Severe Hospitalization in Patients Admitted With Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Community Hospital: A Retrospective Chart Review","display_name":"Predictors of Severe Hospitalization in Patients Admitted With Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Community Hospital: A Retrospective Chart Review","publication_year":2026,"publication_date":"2026-10-11","ids":{"openalex":"https://openalex.org/W7221464124","doi":"https://doi.org/10.7759/cureus.117762","pmid":"https://pubmed.ncbi.nlm.nih.gov/43011837","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13750025"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.117762","doi":"https://doi.org/10.7759/cureus.117762","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117762","pdf_url":"https://www.cureus.com/articles/523341-predictors-of-severe-hospitalization-in-patients-admitted-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-a-community-hospital-a-retrospective-chart-review.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/523341-predictors-of-severe-hospitalization-in-patients-admitted-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-a-community-hospital-a-retrospective-chart-review.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5158368922","display_name":"Prabin Thapa","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Prabin Thapa","raw_affiliation_strings":["Family Medicine, Jackson Park Hospital, Chicago, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Family Medicine, Jackson Park Hospital, Chicago, USA","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5158368922"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"10","first_page":"e117762","last_page":"e117762"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10322","display_name":"Respiratory Support and Mechanisms","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10051","display_name":"Asthma and respiratory diseases","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-exacerbation-of-copd","display_name":"COPD exacerbations","score":0.9229999780654907},{"id":"https://openalex.org/keywords/community-hospitals","display_name":"community hospitals","score":0.5989999771118164},{"id":"https://openalex.org/keywords/30-day-readmission","display_name":"30-day readmission","score":0.8460000157356262},{"id":"https://openalex.org/keywords/intensive-care-unit-admission","display_name":"intensive care unit admission","score":0.7789999842643738},{"id":"https://openalex.org/keywords/endotracheal-intubation","display_name":"endotracheal intubation","score":0.902999997138977},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.7710000276565552},{"id":"https://openalex.org/keywords/congestive-heart-failure","display_name":"congestive heart failure","score":0.875},{"id":"https://openalex.org/keywords/hypercapnia","display_name":"hypercapnia","score":0.9959999918937683},{"id":"https://openalex.org/keywords/non-invasive-ventilation","display_name":"non-invasive ventilation","score":0.7269999980926514},{"id":"https://openalex.org/keywords/discharge-against-medical-advice","display_name":"discharge against medical advice","score":0.6970000267028809},{"id":"https://openalex.org/keywords/in-hospital-mortality","display_name":"in-hospital mortality","score":0.6940000057220459},{"id":"https://openalex.org/keywords/health-care-utilization","display_name":"health care utilization","score":0.5189999938011169},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.4699999988079071}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9915000200271606},{"id":"https://openalex.org/C2992779976","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Pulmonary disease","level":2,"score":0.6450999975204468},{"id":"https://openalex.org/C2777014857","wikidata":"https://www.wikidata.org/wiki/Q1383410","display_name":"Exacerbation","level":2,"score":0.5683000087738037},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5455999970436096},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.5277000069618225},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5094000101089478},{"id":"https://openalex.org/C2780861865","wikidata":"https://www.wikidata.org/wiki/Q4677923","display_name":"Acute exacerbation of chronic obstructive pulmonary disease","level":3,"score":0.5083000063896179},{"id":"https://openalex.org/C190812933","wikidata":"https://www.wikidata.org/wiki/Q28923","display_name":"Chart","level":2,"score":0.4142000079154968},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3366999924182892},{"id":"https://openalex.org/C2776780178","wikidata":"https://www.wikidata.org/wiki/Q199804","display_name":"COPD","level":2,"score":0.3319000005722046},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.3310999870300293},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.3199999928474426},{"id":"https://openalex.org/C2987552334","wikidata":"https://www.wikidata.org/wiki/Q383126","display_name":"Chronic disease","level":2,"score":0.304500013589859},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.29510000348091125},{"id":"https://openalex.org/C2910217193","wikidata":"https://www.wikidata.org/wiki/Q4677923","display_name":"Copd exacerbation","level":4,"score":0.260699987411499},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.2565999925136566},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.2535000145435333}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.117762","doi":"https://doi.org/10.7759/cureus.117762","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117762","pdf_url":"https://www.cureus.com/articles/523341-predictors-of-severe-hospitalization-in-patients-admitted-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-a-community-hospital-a-retrospective-chart-review.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmid:43011837","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/43011837","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13750025","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13750025/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.7759/cureus.117762","doi":"https://doi.org/10.7759/cureus.117762","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117762","pdf_url":"https://www.cureus.com/articles/523341-predictors-of-severe-hospitalization-in-patients-admitted-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-a-community-hospital-a-retrospective-chart-review.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7221464124.pdf","grobid_xml":"https://content.openalex.org/works/W7221464124.grobid-xml"},"referenced_works_count":13,"referenced_works":["https://openalex.org/W2010967671","https://openalex.org/W2053025766","https://openalex.org/W2107371157","https://openalex.org/W2123415110","https://openalex.org/W2140760909","https://openalex.org/W2329899462","https://openalex.org/W2491609588","https://openalex.org/W2753000083","https://openalex.org/W3033975634","https://openalex.org/W3092849554","https://openalex.org/W4313397722","https://openalex.org/W4388750551","https://openalex.org/W4402580611"],"related_works":["https://openalex.org/W2157745657","https://openalex.org/W2779757288","https://openalex.org/W2900871427","https://openalex.org/W3207534920","https://openalex.org/W2724770121","https://openalex.org/W23900508","https://openalex.org/W3032424722","https://openalex.org/W2366522371","https://openalex.org/W4414257073","https://openalex.org/W2105105793"],"abstract_inverted_index":{"Background":[0],"Hospitalization":[1],"for":[2,116,319,326],"acute":[3],"exacerbation":[4],"of":[5,88,220,249,338,399],"chronic":[6],"obstructive":[7],"pulmonary":[8],"disease":[9],"(AECOPD)":[10],"is":[11],"associated":[12,245,276,310,364,375],"with":[13,149,246,277,311,365,376],"substantial":[14],"morbidity":[15],"and":[16,107,143,169,211,233,265,302,323,350,354,361,369,371],"healthcare":[17],"utilization":[18,353],"in":[19,28,124,185,193,199,203,208,214,282,379],"community":[20,53,334],"hospitals.":[21],"Because":[22],"in-hospital":[23,99,206],"mortality":[24,207],"may":[25,35],"be":[26],"infrequent":[27],"single-center":[29,47],"chart":[30,49,336],"reviews,":[31],"composite":[32,75,118,181,222,321,367],"morbidity/utilization":[33],"endpoints":[34],"better":[36],"capture":[37],"clinically":[38],"meaningful":[39],"adverse":[40,76,182,250,345,366],"hospital":[41,54,77,335,346],"trajectories.":[42],"Methods":[43],"We":[44],"conducted":[45],"a":[46,52,74,133,155],"retrospective":[48],"review":[50,337],"at":[51],"using":[55,164],"unique-patient":[56],"index":[57,188,342],"admissions":[58],"only":[59],"(earliest":[60],"admission":[61,191],"per":[62,236],"medical":[63,146],"record":[64],"number":[65],"(MRN)),":[66],"yielding":[67],"163":[68,339],"patients.":[69],"The":[70,180],"primary":[71,129],"outcome":[72,183],"was":[73,114,162,316,348],"course":[78,347],"defined":[79],"as":[80,154,173],"any":[81],"ICU":[82,190],"admission,":[83],"endotracheal":[84],"intubation,":[85],"prolonged":[86,355],"length":[87],"stay":[89],"(LOS":[90],">":[91],"5":[92],"days;":[93],"cohort":[94],"median),":[95],"30-day":[96,212,377],"readmission,":[97],"or":[98],"mortality.":[100,359],"Baseline":[101],"comparisons":[102],"used":[103,115,132],"Mann-Whitney":[104],"U":[105],"tests":[106],"chi-square/Fisher's":[108],"exact":[109],"tests.":[110],"Multivariable":[111],"logistic":[112,152,256],"regression":[113,153],"the":[117,128,221,253,283,320,327],"outcome.":[119],"Thirty-day":[120],"readmission":[121,130,213,257,329,378],"(post-discharge)":[122],"occurred":[123,184,192],"21":[125],"cases;":[126],"therefore,":[127],"analysis":[131,157,219],"pre-specified":[134],"parsimonious":[135,254,328,380],"model":[136,322],"(age,":[137],"congestive":[138],"heart":[139],"failure":[140],"(CHF),":[141],"creatinine,":[142],"discharge":[144],"against":[145],"advice":[147],"(AMA))":[148],"Firth":[150,284],"penalized":[151,285],"sensitivity":[156],"to":[158],"mitigate":[159],"overfitting.":[160],"LOS":[161,290],"modeled":[163],"negative":[165,288],"binomial":[166,289],"regression.":[167],"AUROC":[168,317,324],"calibration":[170],"were":[171,244,275,280,309,363,374],"assessed":[172],"internal/apparent":[174,385],"performance":[175],"(no":[176],"external":[177,388],"validation).":[178],"Results":[179],"105/163":[186],"(64.4%)":[187],"admissions.":[189],"53/163":[194],"(32.5%),":[195],"noninvasive":[196],"ventilation":[197],"(NIV)":[198],"58/163":[200],"(35.6%),":[201],"intubation":[202,303],"9/163":[204],"(5.5%),":[205],"3/163":[209],"(1.8%),":[210],"21/163":[215],"(12.9%).":[216],"In":[217,252,287,332],"multivariable":[218],"outcome,":[223],"CHF":[224,259,360,370],"(adjusted":[225,293],"odds":[226,248],"ratio":[227,296],"(aOR)":[228],"3.11,":[229],"95%":[230,241,262,272,299,306],"CI":[231,242,263,273,300,307],"1.15-8.43)":[232],"hypercapnia":[234,362],"(PaCO\u2082":[235],"10":[237],"mmHg;":[238],"aOR":[239,270],"1.94,":[240],"1.25-3.00)":[243],"higher":[247],"course.":[251],"standard":[255],"model,":[258],"(aOR":[260],"4.16,":[261],"1.54-11.20)":[264],"creatinine":[266],"(per":[267],"0.5":[268],"mg/dL;":[269],"1.23,":[271],"1.05-1.45)":[274],"readmission;":[278],"estimates":[279,386],"attenuated":[281],"model.":[286,330],"modeling,":[291],"NIV":[292],"incidence":[294],"rate":[295],"(aIRR)":[297],"1.58,":[298],"1.03-2.42)":[301],"(aIRR":[304],"2.97,":[305],"1.36-6.49)":[308],"longer":[312],"LOS.":[313],"Apparent":[314],"discrimination":[315],"0.7192":[318],"0.722":[325],"Conclusion":[331],"this":[333],"unique":[340],"AECOPD":[341],"admissions,":[343],"an":[344],"common":[349],"largely":[351],"reflected":[352],"recovery":[356],"rather":[357],"than":[358],"outcomes,":[368],"renal":[372],"dysfunction":[373],"modeling.":[381],"Performance":[382],"metrics":[383],"represent":[384],"without":[387],"validation;":[389],"larger,":[390],"externally":[391],"validated":[392],"studies":[393],"are":[394],"needed":[395],"before":[396],"clinical":[397],"deployment":[398],"prediction":[400],"tools.":[401]},"counts_by_year":[],"updated_date":"2026-11-13T13:42:25.865203","created_date":"2026-10-12T00:00:00"}
