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Título:
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Clinical variables predicting the risk of a hospital stay for longer than 7 days in patients with severe acute exacerbations of chronic obstructive pulmonary disease: a prospective study
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Autor/a:
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Crisafulli, Ernesto; Ielpo, Antonella; Barbeta, Enric; Ceccato, Adrian; Huerta, Arturo; Gabarrús, Albert; Soler Porcar, Néstor; Chetta, Alfredo; Torres Martí, Antoni
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Notas:
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BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients may experience an acute exacerbation (AECOPD) that requires hospitalisation. The length of hospital stay (LHS) has a great economic impact on the health-care system. Knowing the predictors of prolonged LHS could help to identify possible interventions. METHODS: We performed a prospective study to identify the clinical predictors of prolonged LHS in patients hospitalised for AECOPD. We divided the study sample by LHS into normal (≤7 days) and prolonged LHS (> 7 days) groups. Outcomes were the need for non-invasive and invasive mechanical ventilation (NIMV and IMV), intensive care unit (ICU) admission, and the 3-year mortality. RESULTS: We enrolled 437 patients, of which 213 and 224 had normal LHS and prolonged LHS, respectively. Patients with a prolonged LHS had more prior hospitalisations for AECOPD, a worse mMRC (modified Medical Research Council) dyspnoea score, a higher prevalence of long-term oxygen therapy and a higher rate of congestive heart disease. During the current admission, this group also tended to require NIMV, IMV and ICU admission and the mortality risks at 6 months, 1 year and 3 years were higher. In the multivariate regression analysis, an mMRC dyspnoea score ≥ 2 (odds ratio-OR 2.24; 95% confidence interval-CI 1.34 to 3.74; p = 0.002) and the presence of acute respiratory acidosis (OR 2.75; 95% CI 1.49 to 5.05; p = 0.001) predicted a prolonged LHS at admission. CONCLUSIONS: The presence of an mMRC ≥2 and acute respiratory acidosis at admission independently increased the risk of a prolonged LHS for AECOPD. |
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Materia(s):
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-Malalties pulmonars obstructives cròniques
-Malalts hospitalitzats
-Factors de risc en les malalties
-Chronic obstructive pulmonary diseases
-Hospital patients
-Risk factors in diseases |
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Derechos:
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cc-by (c) Crisafulli, Ernesto et al., 2018
http://creativecommons.org/licenses/by/3.0/es
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Tipo de documento:
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Artículo
Artículo - Versión publicada |
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Editor:
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BioMed Central
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Compartir:
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