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 Diabetes mellitus type 2 in hospitalized patients with chronic obstructive pulmonary disease

2015 ◽  
Author(s):  
Evgeni Mekov ◽  
Yanina Slavova ◽  
Marianka Genova ◽  
Adelina Tsakova ◽  
Dimitar Kostadinov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bulgarian Population

Diabetes mellitus (DM) affects 2-37% of patients with chronic obstructive pulmonary disease (COPD), with results being highly variable between studies. DM may also correlate with disease characteristics.The aim of this study was to examine the prevalence of DM and its correlation with comorbidities and COPD characteristics in patients with COPD admitted for exacerbation. 152 patients were studied for presence of DM. All of them were also assessed for vitamin D status and metabolic syndrome (MS). Data were gathered for smoking status and exacerbations during the last year. All patients completed CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires and underwent spirometry. Duration of current hospital stay was recorded. 13.2% (20/152) of patients are taking medications for DM. Additional 21.7% (33/152) have newly discovered DM and 30.9% (47/152) have prediabetes. Only 34.2% of the studied patients do not have DM or prediabetes. 37% (40/108) of males have DM vs. 29,5% (13/44) of females (p=0.379). The prevalence of DM in this study is significantly higher when compared to an unselected Bulgarian population (12,8% in subjects over 45 years). 91% of patients with newly discovered diabetes had glycated hemoglobin (HbA1c)≥6,5% suggesting prolonged hyperglycemia. There is a correlation between the presence of DM and MS (p=0.008). The presence of DM is associated with more severe exacerbations (hospitalizations) during the previous year (p=0.003) and a longer hospital stay (p=0.006). DM is not associated with reduced quality of life and worse pulmonary function. The patients with COPD admitted for exacerbation are at great risk for impaired glucose metabolism which is associated with worse COPD characteristics. The majority of the patients in this study are unaware of having DM.

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 The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

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