To investigate the risk of acute exacerbations and all-cause readmission in patients with pre-chronic obstructive pulmonary disease (COPD).

A total of 127 patients with chronic airway diseases admitted to our hospital from October 2021 to October 2023 were selected. Among them, 49 patients with chronic respiratory symptoms and post-bronchodilator forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) ≥ 0.7 were assigned to the observation group, and 78 patients with post-bronchodilator FEV₁/FVC<0.7 were assigned to the control group. Clinical data, chest imaging findings, laboratory results, and treatment details were collected. Acute exacerbation events and all-cause readmissions were recorded during follow-up. A Cox proportional hazards model was used to analyze the association between lung function classification and acute exacerbations as well as all-cause readmission within 12 months after discharge.

Compared with the control group, the observation group had lower COPD assessment test (CAT) scores [(17.28±5.67) vs. (19.75±6.03), P=0.021], higher arterial partial pressure of oxygen (PaO₂) [(84.16±14.88) mmHg vs. (77.85±16.24) mmHg, P=0.025], and lower arterial partial pressure of carbon dioxide (PaCO₂) [(41.08±9.45) mmHg vs. (44.92±11.53) mmHg, P=0.044]. The observation group also had lower usage rates of glucocorticoids [30(61.22%) vs. 62(79.49%), P=0.022], inhaled bronchodilators [28(57.14%) vs. 59(75.64%), P=0.025], methylxanthines [26(53.06%) vs. 59(75.64%), P=0.007], and antibiotics [36(73.47%) vs. 70(89.74%), P=0.012]. No significant differences were found in chest imaging or laboratory indicators between the two groups (P>0.05). During follow-up, the observation group had 6 cases of acute exacerbation (12.24%, 95%CI: 8.55~18.65) and the control group had 15 cases (19.25%, 95%CI: 14.70~23.48) (P<0.05); the observation group had 5 cases of all-cause readmission (10.20%, 95%CI: 9.80~13.89) and the control group had 12 cases (15.38%, 95%CI: 14.12~16.75) (P<0.05). Multivariate Cox regression analysis showed that FEV₁/FVC<0.7 was a risk factor for acute exacerbation (HR=1.925, 95%CI: 1.138~3.102, P<0.001) and all-cause readmission (HR=2.488, 95%CI: 1.685~3.615, P<0.001) within 12 months after discharge.

Patients with pre-COPD have a risk of acute exacerbations and readmission. Patients with confirmed COPD have definite airflow limitation, and their medium-term risks of acute exacerbation and readmission are higher than those of pre-COPD patients. Clinical attention should be paid to standardized follow-up, risk factor control, and dynamic monitoring of lung function in pre-COPD patients to reduce the risk of adverse outcomes.