Hospital Readmissions: Patient, Carer and Clinician Views

2006 ◽  
Vol 5 (3) ◽  
pp. 104-107
Author(s):  
Elinor Kirk ◽  
◽  
M K Prasad ◽  
Ahmed H Abdelhafiz ◽  
◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Medical Condition ◽  
Hospital Readmissions ◽  
Chronic Obstructive ◽  
Medical Patients ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome

Aim: To explore patients, carers, and clinician views and identify factors, which affect the likelihood of hospital readmission. Methods: A cross sectional retrospective study of adult medical patients readmitted to hospital within 28 days of discharge. Medical and nursing records were reviewed and patients and their carers were interviewed regarding their views about their discharge and readmission. Data were collected regarding demographic, social and medical profiles. Results: Seventy-seven patients were readmitted over a five-week period out of 1289 patients discharged during the previous five weeks, representing a 6% readmission rate. Mean (SD) age of readmitted patients was 71.3 (14.6) years. Forty patients (51.9%) were aged ≥75 and 39 (50.6%) were males. Mean (SD) number of comorbidities was 3.68 (1.82). Mean (SD) number of medications was 7.79 (4.14). Most common reasons for readmission were exacerbation of chronic obstructive pulmonary disease and acute coronary syndrome. Mean (SD) time to readmission was 11.6 (8.2) days. Fifty (64.9%) patients were readmitted within 14 days of discharge. Forty eight (62.3%) patients were readmitted with the same medical condition as their previous discharge. Fifty (64.9%) patients and 45 (66.2%) carers felt that discharge was appropriate. Forty five (58.0%) patients and 44 (57.0%) carers thought that readmission was unavoidable. Clinicians considered 56 (72.7%) discharges appropriate and 55 (71.5%) readmissions unavoidable. A trend towards higher readmission rate among patients ≥ 75 years was noted (7.2% vs 5.1%, p=0.1). Conclusion: Although the majority of discharges are appropriate, up to a third of readmissions may be avoidable in the views of carers, patients and clinicians. Patients and carers should be consulted regarding readiness for discharge before leaving hospital.

scholarly journals Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease?

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 159
Author(s):  
Ana L. Fernandes ◽  
Inês Neves ◽  
Graciete Luís ◽  
Zita Camilo ◽  
Bruno Cabrita ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Intraclass Correlation ◽  
Oxygen Desaturation ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Stand Test ◽  
Sit To Stand

Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the functional status. The aim of this study was to compare the 1STST to the 6MWT in the evaluation of exertional desaturation. Methods: This was a cross-sectional study including 30 stable COPD patients who performed the 6MWT and 1STST on the same day. Six-minute walking distance (6MWD), number of 1STST repetitions (1STSTr), and cardiorespiratory parameters were recorded. Results: A significant correlation was found between the 6MWD and the number of 1STSTr (r = 0.54; p = 0.002). The minimum oxygen saturation (SpO2) in both tests showed a good agreement (intraclass correlation coefficient (ICC) 0.81) and correlated strongly (r = 0.84; p < 0.001). Regarding oxygen desaturation, the total agreement between the tests was 73.3% with a fair Cohen’s kappa (κ = 0.38; p = 0.018), and 93.33% of observations were within the limits of agreement for both tests in the Bland–Altman analysis. Conclusion: The 1STST seems to be a capable tool of detecting exercise-induced oxygen desaturation in COPD. Because it is a less time- and resources-consuming test, it may be applied during the outpatient clinic consultation to regularly evaluate the exercise capacity and exertional desaturation in COPD.

scholarly journals Methylation of SERPINA1 gene promoter may predict chronic obstructive pulmonary disease in patients affected by acute coronary syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
John Charles Rotondo ◽  
Giorgio Aquila ◽  
Lucia Oton-Gonzalez ◽  
Rita Selvatici ◽  
Paola Rizzo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Coronary Syndrome ◽  
Pulmonary Disease ◽  
Blood Cells ◽  
Gene Promoter ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Copd Patients ◽  
Potential Biomarker

Abstract Background Diagnostic biomarkers for detecting chronic obstructive pulmonary disease (COPD) in acute coronary syndrome (ACS) patients are not available. SERPINA1, coding for the most potent circulating anti-inflammatory protein in the lung, has been found to be differentially methylated in blood cells from COPD patients. This study aimed to investigate the methylation profile of SERPINA1 in blood cells from ACS patients, with (COPD+) or without COPD (COPD−). Methods Blood samples were from 115 ACS patients, including 30 COPD+ and 85 COPD− according to lung function phenotype, obtained with spirometry. DNA treated with sodium bisulfite was PCR-amplified at SERPINA1 promoter region. Methylation analysis was carried out by sequencing the PCR products. Lymphocytes count in ACS patients was recorded at hospital admission and discharge. Results SERPINA1 was hypermethylated in 24/30 (80%) COPD+ and 48/85 (56.5%) COPD− (p < 0.05). Interestingly, at hospital discharge, lymphocytes count was higher in COPD− patients carrying SERPINA1 hypermethylated (1.98 × 103 ± 0.6 cell/µl) than in COPD− carrying SERPINA1 hypomethylated (1.7 × 103 ± 0.48 cell/µl) (p < 0.05). Conclusions SERPINA1 is hypermethylated in blood cells from COPD+ patients. COPD− carrying SERPINA1 hypermethylated and high lymphocytes count may be at risk of COPD development. Therefore, SERPINA1 hypermethylation may represent a potential biomarker for predicting COPD development in ACS patients.

scholarly journals Associations of the Stair Climb Power Test With Muscle Strength and Functional Performance in People With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

2010 ◽  
Vol 90 (12) ◽  
pp. 1774-1782 ◽  
Author(s):  
Marc Roig ◽  
Janice J. Eng ◽  
Donna L. MacIntyre ◽  
Jeremy D. Road ◽  
W. Darlene Reid
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Functional Performance ◽  
Knee Extensor ◽  
Chronic Obstructive ◽  
Flexor Muscle ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Power Test ◽  
Muscle Torque

Background The Stair Climb Power Test (SCPT) is a functional test associated with leg muscle power in older people. Objective The purposes of this study were to compare the results of the SCPT in people with chronic obstructive pulmonary disease (COPD) and people who were healthy and to explore associations of the SCPT with muscle strength (force-generating capacity) and functional performance. Design The study was a cross-sectional investigation. Methods Twenty-one people with COPD and a predicted mean (SD) percentage of forced expiratory volume in 1 second of 47.2 (12.9) and 21 people who were healthy and matched for age, sex, and body mass were tested with the SCPT. Knee extensor and flexor muscle torque was assessed with an isokinetic dynamometer. Functional performance was assessed with the Timed “Up & Go” Test (TUG) and the Six-Minute Walk Test (6MWT). Results People with COPD showed lower values on the SCPT (28%) and all torque measures (∼32%), except for eccentric knee flexor muscle torque. In people with COPD, performance on the TUG and 6MWT was lower by 23% and 28%, respectively. In people with COPD, the SCPT was moderately associated with knee extensor muscle isometric and eccentric torque (r≥.46) and strongly associated (r=.68) with the 6MWT. In people who were healthy, the association of the SCPT with knee extensor muscle torque tended to be stronger (r≥.66); however, no significant relationship between the SCPT and measures of functional performance was found. Limitations The observational design of the study and the use of a relatively small convenience sample limit the generalizability of the findings. Conclusions The SCPT is a simple and safe test associated with measures of functional performance in people with COPD. People with COPD show deficits on the SCPT. However, the SCPT is only moderately associated with muscle torque and thus cannot be used as a simple surrogate for muscle strength in people with COPD.

scholarly journals Correlation between 6-minute walk distance and spirometry parameters in stable chronic obstructive pulmonary disease patients

2018 ◽  
Vol 7 (1) ◽  
pp. 34
Author(s):  
Ruchita B. Hajare ◽  
Raziya Nagarwala ◽  
Ashok Shyam ◽  
Parag Sancheti
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Strong Positive Correlation ◽  
Walk Test ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Six Minute Walk Test ◽  
Tertiary Center ◽  
Minute Walk

Background: Six minute walk test (6MWT) is a sub-maximal exercise test, used as a clinical indicator of the functional capacity, in patients with cardiopulmonary diseases. It is simple, objective and reproducible test. The present study was designed to assess correlation of six minute walk test with spirometry parameters, in patients with chronic obstructive pulmonary disease.Methods: In this cross sectional study, fifty patients diagnosed with chronic obstructive pulmonary disease (GOLD criteria) coming to tertiary center were recruited according to inclusion and exclusion criteria. All patients underwent spirometric measurement. Spirometric indices including FEV1, FVC, FEV1/FVC and MVV were tested using computerized spirometer. 6MWT was performed following American Thoracic Society (ATS) guidelines. Percent (%) predicted 6MWD was calculated. Correlation between spirometry and 6MWT was assessed.Results: It was found that correlation between 6MWT and spirometry is statistically significant. There is significant strong positive correlation between percent predicted 6MWD and FEV1 (r=0.850 and p= <0.001), whereas there is significant moderate correlation between percent predicted 6MWD and FVC (r=0.554 and p= <0.001), FEV1/FVC (r=0.509 and p= <0.001) and MVV (r=0.615 and p= <0.001).Conclusions: In chronic obstructive pulmonary disease, percent predicted 6mwd significantly correlated with the spirometry parameters (FEV1, FVC, FEV1/FVC, and MVV). 6MWD decreases as there is decline in the pulmonary function. 6MWT can be a useful replacement of spirometry in assessment of severity of COPD.

Sign in / Sign up

Export Citation Format

Share Document