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Title: | 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 |
Author: | Crisafulli, Ernesto Ielpo, Antonella Barbeta, Enric Ceccato, Adrian Huerta, Arturo Gabarrús, Albert Soler Porcar, Néstor Chetta, Alfredo Torres Martí, Antoni |
Keywords: | Malalties pulmonars obstructives cròniques Malalts hospitalitzats Factors de risc en les malalties Chronic obstructive pulmonary diseases Hospital patients Risk factors in diseases |
Issue Date: | 27-Dec-2018 |
Publisher: | BioMed Central |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/s12931-018-0951-4 |
It is part of: | Respiratory Research, 2018, vol. 19, num. 1, p. 261-273 |
URI: | http://hdl.handle.net/2445/132839 |
Related resource: | https://doi.org/10.1186/s12931-018-0951-4 |
ISSN: | 1465-993X |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Medicina) |
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