Singh U, et al. - Researchers determined the association of chronic rhinitis (CR) with the risk of asthma or chronic obstructive pulmonary disease (COPD)-related early hospital readmission rates. They found a significant association between comorbid CR and 30-day asthma- and COPD-related readmissions. Findings have utility with regard to guiding healthcare professionals to focus on outpatient management of both the upper and lower respiratory tracts in order to reduce early readmission of asthma and COPD patients.

Methods

• In this retrospective cohort study, researchers used the asthma- and COPD-related hospital encounter and patient comorbidity data between June 15, 2012 - July 19, 2017 from a large hospital care system in Cincinnati, Ohio.
• Study participants were patients (any gender, race or socioeconomic status, and of all ages) with a primary discharge diagnosis of asthma (n=4,754 patients, 10,111 encounters) and COPD (n=2,176 patients, 4,748 encounters) based on ICD-10-CM codes.
• They used ICD-10-CM codes to determine relevant comorbidities, including comorbid allergic rhinitis (AR) or non-allergic rhinitis (NAR) in such patients.
• They used Cox proportional hazards models to determine the link between 30-day asthma or COPD-related hospital readmission (1,670 such encounters for asthma and 736 for COPD) and comorbid CR in the affected patients.
• Using multivariate-adjusted hazard ratios (HR), adjusted for relevant patient comorbidities, they compared 30-day asthma- and COPD-related readmissions of patients with CR with those patients without a CR diagnosis.

Results

• A total of 4,754 asthma and 2,176 COPD patients were analyzed.
• The median follow-up period (+interquartile range) for asthma and for COPD was 980 (+760) days and 553 (+827) days, respectively.
• Findings demonstrated significantly higher HR for 30-day asthma- or COPD-related readmission rates in patients with AR [HR=4.4 (3.9, 5.0) and 2.4 (1.7, 3.2), respectively] or NAR [HR=3.7 (2.9, 4.9) and 2.6 (1.8, 3.7), respectively), vs non-rhinitis patients.
• For asthma, higher HRs were observed in both AR and NAR, vs all other co-morbidities analyzed.
• They found that, for COPD, both AR and NAR had HRs to the level as obesity and hypertension