scholarly journals Analysis of Direct Treatment Cost for Exacerbation of Chronic Obstructive Pulmonary Disease in E Hospital from October 2019 to March 2020

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Bui Thi Xuan ◽  
Ngo Tien Thanh ◽  
To Khanh Linh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Treatment Cost ◽  
Respir Crit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
Exacerbation Of Copd ◽  
The Cost

This study analyzes the direct treatment cost for exacerbation of chronic obstructive pulmonary disease (COPD) at the Department of Pulmonology, E Hospital from October 2019 to March 2020. The study results show that the average direct treatment cost for exacerbation of COPD was VND 9,102,311.71; the highest cost was VND 36,304,614 and the lowest cost, VND 2,309,961. Among the direct treatment cost components, drug cost showed the highest proportion, followed by hospital bed, then surgical procedures, tests, diagnostic imaging, functional exploration, examination and medical supplies. The cost of antibiotics accounted for 57.76% of the drug cost. The average number of hospitalization days was 10.77, closely relating to the direct cost. Besides, age and comorbidity also affected the number of hospitalization days. The average health insurance support for each patient was up to 94.46% of the total treatment cost. The results also show that the cost of treatment in Vietnam is lower than some countries in the region and the proportions of the cost components presented in different studies in Vietnam are different. Keywords Direct cost, exacerbation of COPD, E hospital. [1] Ngo Quy Chau, Nguyen Lan Viet, Nguyen Dat Anh, Pham Quang Vinh, Internal Pathology, Medical Publishing House 1 (2018) 42-50 (in Vietnamese).[2] R.A. Pauwels, A.S. Buist, P.M.A. Calverley, C. R. Jenkins, S. Hurd Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 163 (2001) 1256–1276. https://doi.org/10.1164/ajrccm.163.5.2101039[3] https://www.chestnet.org/News/Press-Releases /2014/07/CDC-reports-36-billion-in-annual financial-cost-of-COPD-in-US (15/10/2019)[4] S.D. Sullivan, S.D. Ramsey, T.A. Lee, The economic burden of COPD. Chest 2000 Feb 117(2), 5S-9S.https://journal.chestnet.org/article/S0012-3692(15)52748-7/fulltext[5] Vanfleteren, E.G.W. Lowie, et al Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease American journal of respiratory and critical care medicine 187(7) (2013) 728-735. https://www.atsjournals.org/doi/full/10.1164/rccm.201209-1665oc [6] Doan Quynh Huong Analysis of direct costs of inpatient treatment for EPI in Respiratory Center of Bach Mai Hospital from 2013-2015, 2017 (in Vietnamese).[7] Vu Xuan Phu, Duong Viet Tuan, Nguyen Thu Ha et al., Inpatient treatment costs of patients with chronic obstructive pulmonary disease at central lung hospital, 2009, Journal of Practical Medicine 1 (2012) 51-53 (in Vietnamese).http://yhth.vn/chi-phi-dieu-tri-noi-tru-cua-benh-nhan-benh-phoi-tac-nghen-man-tinh-tai-benh-vien-phoi-trung-uong-nam-2009_t3254.aspx[8] C.S. Rand, M. Nides, M.K. Cowles, R.A. Wise, J. Connett, Long-term metered-dose inhaler adherence in a clinical trial. The lung health study research group. Am J Respir Crit Care Med, Aug 152(2) (1995) 580-8. https://doi.org/10.1164/ajrccm.152.2.7633711[9] Phan Thi Thanh Hoa, Clinical features, clinical and direct treatment costs of patients with chronic obstructive pulmonary disease at Respiratory Center - Bach Mai Hospital Graduation thesis general practitioner, Hanoi Medical University 2013 (in Vietnamese).  

Serum Electrolyte in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 13 (1) ◽  
pp. 9-13
Author(s):  
Chandra Prasad Acharya ◽  
Kalpana Paudel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Serum Electrolyte ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Electrolyte Disorder ◽  
The Mean ◽  
Exacerbation Of Copd

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity worldwide. Though COPD is mainly a chronic disease, many patients experience exacerbations that are related to worst survival outcome, especially with abnormal serum electrolyte level. The objective of this study was to evaluate serum electrolyte levels among the patients with acute exacerbation of COPD. Methods: Structured questionnaire and patients’ charts were used to collect data. Data was analyzed using Statistical Package for the Social Sciences (SPSS) software version 16.0 and descriptive statistics were used to generate the research findings. Results: The mean age of the patients with Acute exacerbation of COPD was 69.57± 9.765 years. Among 100 patients, (83%) belonged to the age group of 60 years and above, (54%) were male, (74%) were married, (52%) were illiterate and (41%) were engaged in agriculture, (41%) consumed alcohol and (67%) were smokers. Dyspnoea (90%) was the most common symptom. The mean level of sodium and potassium were 133.8±4.830 mEq/L, 3.6±0.533 mmol/L, respectively. Fifty seven percent patients had electrolyte disorder. More than half (51%) had hyponatremia and (40%) had hypokalemia. The average value of pH, PaCO2 and PaO2 are 7.34 ± 0.727, 46.64 ± 9.787 mm Hg and 69.38 ± 9.255 mm Hg respectively. Among them, (18%) were in respiratory failure. Conclusion: This study concluded that hyponatremia and hypokalemia are prevalent electrolyte disorder with AE of COPD patients. Therefore, we recommend routine monitoring of the serum electrolytes for better outcomes of patients.

scholarly journals P Wave Signal-Averaged Electrocardiography in Patients with Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 53 (4) ◽  
pp. 315-320 ◽  
Author(s):  
C.A. Buzea ◽  
Anca Rodica Dan ◽  
Caterina Delcea ◽  
M.I. Balea ◽  
Daniela Gologanu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Root Mean Square ◽  
Risk Evaluation ◽  
P Wave ◽  
Chronic Obstructive ◽  
Mean Square ◽  
Supraventricular Arrhythmias ◽  
Obstructive Pulmonary Disease ◽  
Exacerbation Of Copd

Abstract Introduction. Chronic obstructive pulmonary disease (COPD) is associated with higher incidence of supraventricular arrhythmias. Atrial late potentials (ALP) detected by P-wave signal-averaged electrocardiography (SAECG) could be useful in detecting the patients at risk for supraventricular arrhythmias. Our objective was to assess the role of P-wave SAECG and ALP detection for arrhythmic risk evaluation of the patients with exacerbated COPD. Methods. We prospectively included 45 patients with exacerbation of COPD and 58 age-matched patients with no history of pulmonary disease in a control group. We performed pulmonary function tests, arterial blood gases, echocardiography, 24-hour Holter monitoring and P-wave SAECG. We measured filtered P-wave duration (FPD), the root mean square (RMS) voltages in the last 40, 30 and 20 ms of the filtered P-wave (RMS 40, RMS 30 and RMS 20), the root mean square voltage of the filtered P-wave potentials (RMS-p), and the integral of the potentials during the filtered P-wave (Integral-p). ALP was defined as FPD > 132 ms and RMS 20 < 2.3 µV. Results. Isolated atrial premature beats (APB) and supraventricular tachycardias (SVT) were more frequent in the COPD group. There were no significant differences between groups regarding the P wave SAECG parameters. In the COPD group none of the supraventricular arrhythmias was correlated with ALP or any P-wave SAECG parameters. Conclusions. The patients with acute exacerbation of COPD but no apparent cardiac disease have a higher incidence of supraventricular arrhythmias. P-wave SAECG analysis and ALP detection have little value in the arrhythmic risk evaluation of these patients.

scholarly journals The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Xuanqi Liu ◽  
Haiyan Ge ◽  
Xiumin Feng ◽  
Jingqing Hang ◽  
Fengying Zhang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Calibration Curve ◽  
Roc Curve ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Copd Patients ◽  
Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients.Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet–lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve.Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients.Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.

scholarly journals Possibilities to prevent acute exacerbation of chronic obstructive pulmonary disease using inhalational therapy. A Report of Expert Panel of Russian Respiratory Society

2018 ◽  
Vol 28 (3) ◽  
pp. 368-380 ◽  
Author(s):  
S. N. Avdeev ◽  
A. S. Belevskiy ◽  
Z. R. Aisanov ◽  
V. V. Arkhipov ◽  
I. V. Leshchenko ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinically Significant ◽  
Long Acting ◽  
Exacerbation Of Copd ◽  
Inhalational Therapy

An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD. 

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

Evaluating the cost-effectiveness of combination inhalers for the management of chronic obstructive pulmonary disease

2020 ◽  
Vol 26 (9) ◽  
pp. 231-233
Author(s):  
Matthew Taylor ◽  
Michelle Green
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cost Effectiveness ◽  
Pulmonary Disease ◽  
Cost Effectiveness Analysis ◽  
Chronic Obstructive ◽  
Valuable Insight ◽  
Obstructive Pulmonary Disease ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Insight Into

Matthew Taylor and Michelle Green provide a valuable insight into methods of vital cost-effectiveness analysis of combination inhalers for the management of chronic obstructive pulmonary disease.

scholarly journals High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Anshul Mittal ◽  
Megha Varshney ◽  
Vidushi Rathi ◽  
Pranav Ish
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
High Flow ◽  
Nasal Cannula ◽  
Chronic Obstructive ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Exacerbation Of Copd

High flow nasal cannula (HFNC) provides warmed and humidified air with flow rates up to 60 liters/min with relatively fixed oxygen content (FiO2). It has been extensively evaluated for hypoxemic respiratory failure and has been used in mild acute respiratory distress syndrome, pre-intubation, bronchoscopy and pediatric obstructive sleep apnea. Recent data has suggested a role in stable hypercapnic chronic obstructive pulmonary disease (COPD) and even in acute exacerbations, though, the use has not been advocated by any guidelines yet. We present a case of acute hypercapnic exacerbation of COPD, intolerant to non-invasive ventilation, showing response and improvement on use of HFNC. This case highlights this potential mechanisms and prospects for the same.

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