Factors predicting a hospital stay of over 3 days in patients with acute exacerbation of chronic obstructive pulmonary disease

2002 ◽  
Vol 251 (6) ◽  
pp. 500-507 ◽  
Author(s):  
F. De La Iglesia ◽  
P. Valino ◽  
S. Pita ◽  
V. Ramos ◽  
C. Pellicer ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Vol 14 ◽  
pp. 175346662096168
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong-Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.

scholarly journals Structured Training to the Patients of Chronic Obstructive Pulmonary Disease Reduces Frequency of Hospital Readmission

2018 ◽  
Vol 6 (1) ◽  
pp. 35-44
Author(s):  
Md Mizanur Rahman ◽  
MA Azhar ◽  
Anup Kumar Saha ◽  
Kamrun Nahar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Hospital Readmission ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Case Group ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Background: Patient education after treatment of acute exacerbation in patients with chronic obstructive pulmonary disease (COPD) prevents frequent hospital readmission and improve quality of life.Objectives: To observe the impact of providing structured training to patients of COPD on repeated hospital admission.Materials and method: This prospective comparative study was carried out in the inpatient department of Medicine and Pulmonology Unit, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from January 2010 to June 2011. A total of 144 admitted patients with COPD with an attack of acute exacerbation were included in this study without having any significant or chronic comorbidity. Of the 144 patients, 72 were randomly allocated for receiving structured training (cases; Group-A) and the rest 72 patients did not receive the training (controls; Group-B).Results: The pertinent demographic characteristics, smoking status, and knowledge about different aspects of COPD, and medications used during acute exacerbation of COPD before intervention were almost similar between the groups. Over 30% of the patients who received structured training needed no hospital admission, 58.3% needed only one and 11.1% needed 2 or more admissions, while the other group required two or more admissions during the same period (p < 0.001). The duration of hospital stay was significantly less in case group. Number of > 2 consultations with physicians was significantly higher in the former group (26.4% vs. 6.9%) (p = 0.002), indicating an increased awareness on the part of that group.Conclusion: Structured training to COPD patients significantly reduced hospitalization and hospital stay for an acute exacerbation in this study.Delta Med Col J. Jan 2018 6(1): 35-44

scholarly journals The Effects of Safflower Yellow on Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Xiao-jin Li ◽  
Yan Kang ◽  
Ru-rong Wang ◽  
Xue-lian Liao ◽  
Xiao-feng Ou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Average Length ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled

Objectives. To evaluate the efficacy of safflower yellow in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods. In a prospective, randomized, controlled trial, 127 patients who met the inclusion criteria were enrolled and were randomly divided into two groups. The control group included 64 patients treated according to the global strategy for diagnosis, management, and prevention of COPD (www.goldcopd.org, updated 2011). The intervention group included 63 patients who received intravenous infusions of safflower yellow (100 mg of safflower yellow dissolved in 250 ml 0.9% saline) once daily for 14 consecutive days in addition to standard diagnosis and treatment. The difference in the average length of the hospital stay between the two groups of patients was determined. The follow-up period was 28 days; the differences in symptoms, clinical indicators, and 28-day mortality in the two groups were compared. Statistical analysis was conducted using SPSS 22.0 software to determine whether there were statistically significant differences (P <0.05) between groups. Results. There were no statistically significant differences between the intervention group and the control group in changes in secondary indicators. There were no statistically significant differences in the 28-day mortality or in the survival curves of the two groups (P=0.496 and P=0.075, respectively). Safflower yellow treatment of AECOPD may relieve the patient’s clinical symptoms, such as dyspnoea, shorten the average length of hospital stay (P=0.006, respectively), and decrease the duration of mechanical ventilation. Conclusion. Safflower yellow in the treatment of AECOPD has a degree of clinical value. This trial is registered under the identifier ChiCTR-IPR-17014176.

scholarly journals Effect of Glycemic Control on Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A411-A411
Author(s):  
Abhraneel Parames Guha
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patients With Diabetes

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is defined as a common preventable and treatable disease that is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. In this article we compared hospital stay between diabetic, non diabetic and prediabetic patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who were treated with corticosteroids. We checked in hospital mortality and 30 day mortality in patients with AECOPD patients with diabetes, Its the first article on this topic from eastern India. Materials and Methods: The study was done in tertiary care centre from November 2017 to April 2019. We included 161 patients with age more than 40 years or more. Patients admitted in hospital with COPD with cough, sputum, dyspnea were included. They were divided into diabetic,prediabetic and non diabetic. We included readmission of patients who were diagnosed previously as AECOPD. Statistical Analysis was performed with help of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). It was a prospective observational study. Results: We found significant association between length of hospital stay and those with AECOPD with diabetes.29.6% of patients with diabetes had a stay of more than two weeks. Hospital stay was found to be 10.8+/-2.30 days in those who had mean random blood sugar (RBS) between 140 -170 mg/dl, 12.98 +/- 2.24 days in those who had RBS between 170–200 mg/dl and 12.62 +/- 3.10 days in those who had RBS more than 200 mg/dl. 89.4% of patient had a BMI (Body mass index) of &lt; 25 kg/square meter. 8.1 % died in hospital and 9.5% died within 30 days of discharge. Among those who were treated with steroids, diabetic patients had a stay of 14.55+/- 0.74 days, compared to prediabetic who had a stay of 14.07+/-1.26 days and non diabetics who had 12.5+/-1.33 days. No association was found between hospital mortality and status of diabetes mellitus. No association was found between 30 day mortality and diabetes mellitus in our study. Conclusion: Diabetes Mellitus and AECOPD are major public health challenges. Whether there is an association between them needs to be addressed, specially in this part of the world. Those patients who were diabetic and treated with steroids had a longer stay than non diabetics and prediabetics. We found no association between hospital mortality and 30 day mortality with diabetes mellitus.

Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Yong Suk Jo ◽  
Chin Kook Rhee ◽  
Kyung Joo Kim ◽  
Kwang Ha Yoo ◽  
Yong Bum Park
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Risk ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Systemic Steroid ◽  
Comorbid Condition ◽  
Obstructive Pulmonary Disease

Abstract Background Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods We included 16,105 patients who had claimed their medical expenses from May 1, 2014, to May 1, 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%) and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities, and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusions Readmission occurred in approximately a quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge and development and evaluation of an effective care programs for COPD patients are necessary.

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