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Títol:
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Exacerbations of chronic obstructive pulmonary disease: An analysis of the care process in a regional hospital emergency department
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Autor/a:
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Abadías, María José; Yuguero Torres, Oriol; Bardés Robles, Ignasi; Casas-Méndez, Luis Fernando; Barbé Illa, Ferran; Batlle Garcia, Jordi de
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Notes:
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To describe the characteristics of patients visiting a Hospital Emergency Department (HED) due to chronic obstructive pulmonary
disease (COPD) exacerbation (AECOPD) and to evaluate their management.
A cross-sectional study of the first 219 patients with AECOPD visiting the HED of the University Hospital Arnau de Vilanova, Lleida,
Spain, was performed from January to May 2016. The data collected included the following: main patient characteristics, diagnostic
tests, applied treatments, response times, discharge destination, need for hospital admission, and re-admissions and deaths at 90
days. Comparisons were made according to sex and need for hospitalization.
The patients consisted of 84% men, with a mean age (standard deviation [SD]) of 75.9 (11) years and a FEV1/FVC of 56 (13)%; 63%
were ex-smokers. The median time (P25–P75) in the HED was 6 (4–10) hours, with shorter waiting times for severe patients.
Additionally, 74% of patients required hospital admission. The percentages of re-admissions and mortality at 90 days were 25% and
14%, respectively. Among female patients, 63% never consumed tobacco, and the most frequent clinical phenotype was asthma
combined with COPD; female patients visited the family doctor sooner after AECOPD than men (4 vs 7 days). Overall, the following
areas of improvement were identified: use of sputum culture (performed in 3% of patients); documentation of variables; patient care
times; and reduction in the time until first medical check-up.
The overall quality of care provided to AECOPD patients was satisfactory and consistent with current clinical guidelines.
Nevertheless, improving the quality of care at the HED requires establishing protocols that ensure that the necessary diagnostic tests
are performed, optimize response times and guarantee that all relevant information is collected. |
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Matèries:
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-Care management
-Chronic obstructive pulmonary disease
-Chronic obstructive pulmonary disease exacerbation
-Emergencies |
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Drets:
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cc-by-nc-nd (c) María José Abadías et al., 2018
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Tipus de document:
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Article
Article - Versió publicada |
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Publicat per:
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Wolters Kluwer Health, Inc
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Compartir:
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