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Abstract
A retrospective study was carried out in a Hong Kong regional hospital with 24-h emergency service, to study the factors associated with shorter time to re-admission after acute exacerbation of chronic obstructive pulmonary disease (COPD). From 1 January 1997 to 31 December 1997, the first admission (index admission) of each patient through the emergency room with COPD/chronic bronchitis/emphysema was included. A total of 551 patients fulfilled the inclusion criteria. The total acute and rehabilitative length of stay (mean ±![Math Eq]()
) was 9·41±11·67 days. Within 1 year after discharge, 327 patients (59·35%) were re-admitted at least once. Median time to first re-admission after discharge was 240 days. By Cox regression analysis, the following factors were independently associated with shorter time to re-admission: hospital admission within 1 year before index admission, total length of stay in index admission >5 days, nursing home residency, dependency in self-care activities, right heart strain pattern on electrocardiogram, on high dose inhaled corticosteroid and actual bicarbonate level >25 mmoll−1. These factors may be relevant in the future planning of healthcare utilization for COPD patients.
) was 9·41±11·67 days. Within 1 year after discharge, 327 patients (59·35%) were re-admitted at least once. Median time to first re-admission after discharge was 240 days. By Cox regression analysis, the following factors were independently associated with shorter time to re-admission: hospital admission within 1 year before index admission, total length of stay in index admission >5 days, nursing home residency, dependency in self-care activities, right heart strain pattern on electrocardiogram, on high dose inhaled corticosteroid and actual bicarbonate level >25 mmoll−1. These factors may be relevant in the future planning of healthcare utilization for COPD patients.Keywords
References
REFERENCES
- Am J Respir Crit Care Med. 1995; 152: S78
- Incidence, prevalence, and mortality: intra- and intercountry differences.in: Hensley MJ Saunders NA Clinical Epidemiology of Chronic Obstructive Pulmonary Disease. Marcel Dekker, New York1989: 23-43
- Trends in chronic obstructive pulmonary disease morbidity and mortality in the United States.Am Rev Respir Dis. 1989; 140: S9-S18
- Respiratory symptoms in elderly Chinese living in Hong Kong.Eur Respir J. 1995; 8: 2055-2061
- Respiratory symptoms and FEV1as predictors of hospitalizations and medication in the following 12 years due to respiratory disease.Eur Respir J. 1989; 2: 710-715
- Cost and outcome of care for patients with chronic obstructive lung disease.Med Care. 1986; 24: 915-924
- Muscle weakness is related to utilization of health care resources in chronic obstructive pulmonary disease patients.Eur Respir J. 1997; 10: 417-423
- Outcomes following acute exacerbation of severe chronic obstructive lung disease.Am J Respir Crit Care Med. 1996; 154: 959-967
- Quality of life and hospital re-admission in patients with chronic obstructive pulmonary disease.Thorax. 1997; 52: 67-71
- Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 1998; 157: 1418-1422
- The value of mucus hypersecretion as a predictor of mortality and hospitalization: an 11-year register based follow-up study of a random population sample of 876 men.Respir Med. 1989; 83: 207-211
- Socioeconomic status, lung function and admission to hospital for chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study.Eur Respir J. 1999; 13: 1109-1114
- Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 1999; 159: 158-164
- Lancet. 1981; 28: 681-686
- Ann Intern Med. 1980; 93: 391-398
- Hypoxemia, hypercapnia, and breathing pattern in patients with chronic obstructive pulmonary disease.Am Rev Respir Dis. 1982; 126: 882-886
- Domiciliary nocturnal intermittent positive pressure ventilation in patients with respiratory failure due to severe chronic obstructive pulmonary disease: long-term follow up and effect on survival.Thorax. 1998; 53: 495-498
- Nasal pressure support ventilation plus oxygen compared with oxygen therapy alone in hypercapnic chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 1995; 152: 538-544
- ‘Hospital at home’ versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial.BMJ. 2000; 321: 1265-1268
- The effect of a respiratory home nurse intervention in patients with chronic obstructive pulmonary disease (COPD).Aust N Z J Med. 1999; 29: 718-725
- Randomised controlled trial of supported discharge in patients with exacerbations of chronic obstructive pulmonary disease.Thorax. 2000; 55: 907-912
- Early discharge for patients with exacerbations of chronic obstructive pulmonary disease: a randomised controlled trial.Thorax. 2000; 55: 902-906
- Home treatment of exacerbations of chronic obstructive pulmonary disease by an acute respiratory assessment service.Lancet. 1998; 351: 1853-1855
- Effects of specialized community nursing care in patients with chronic obstructive pulmonary disease.Heart Lung. 1998; 27: 109-120
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Publication history
Accepted:
June 28,
2001
Received:
January 8,
2001
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© 2001 Harcourt Publishers Ltd. Published by Elsevier Inc.
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