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Analysis of Hospitalizations for COPD Exacerbation: Opportunities for Improving Care
- Source :
- COPD: Journal of Chronic Obstructive Pulmonary Disease. 7:85-92
- Publication Year :
- 2010
- Publisher :
- Informa UK Limited, 2010.
-
Abstract
- Background: Little is known about the actual treatment of patients with chronic obstructive pulmonary disease (COPD), either in the inpatient or outpatient settings. We hypothesized that there are substantial opportunities for improvement in adherence with current guidelines and recommendations. Methods: We reviewed the medical records of all patients hospitalized with acute exacerbation of COPD between January 2005 and December 2006 at 5 New York City hospitals. Results: There were 1285 unique patients with 1653 hospitalizations. Of these 1653, 83% were for patients with a prior history of COPD and 368 (22%) represented repeat admissions during our study period. The majority were treated during their hospitalization with a combination of systemic steroids (85%), bronchodilators (94%) and antibiotics (80%). There were 59 deaths (3.6%). Smoking cessation counseling was offered to 48% of active smokers. Influenza and pneumococcal vaccines were administered to half of eligible patients. On discharge, only 46.0% were prescribed maintenance bronchodilators and 24% were not prescribed any inhaled therapy. Even in the 226 unique patients (17.6%) readmitted at least once during course of the study, on discharge only 44.7% were prescribed maintenance bronchodilators and 23% were not prescribed any regular inhaled therapy. Conclusions: Patients hospitalized with acute exacerbation of COPD generally receive adequate hospital care, but there may be opportunities to improve care pharmacologically and with smoking cessation counseling and vaccination during and after hospitalization.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Chronic bronchitis
Exacerbation
medicine.medical_treatment
Comorbidity
Patient Readmission
Cohort Studies
Pneumococcal Vaccines
Pulmonary Disease, Chronic Obstructive
medicine
Humans
Intensive care medicine
Glucocorticoids
Aged
Quality of Health Care
Retrospective Studies
Aged, 80 and over
COPD
business.industry
Medical record
Retrospective cohort study
Middle Aged
medicine.disease
Patient Discharge
Bronchodilator Agents
Influenza Vaccines
Practice Guidelines as Topic
Emergency medicine
Smoking cessation
Bronchitis
Female
New York City
Smoking Cessation
business
Cohort study
Subjects
Details
- ISSN :
- 15412563 and 15412555
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- COPD: Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi.dedup.....d8444a20f757e129f0ef5a9803b563d1
- Full Text :
- https://doi.org/10.3109/15412551003631683