Chronic Respiratory Disease最新文献

{"title":"Participant-selected music listening during pulmonary rehabilitation in people with chronic obstructive pulmonary disease: A randomised controlled trial.","authors":"Annemarie L Lee, Stacey J Butler, Peter Jung, Imogen N Clark, Jeanette Tamplin, Roger S Goldstein, Dina Brooks","doi":"10.1177/14799731241291065","DOIUrl":"10.1177/14799731241291065","url":null,"abstract":"<p><p>To evaluate the impact of participant-selected music listening as an adjunct to pulmonary rehabilitation (PR) in people with COPD. Adults with COPD referred to PR were randomly assigned to participant-selected music listening (intervention group, [IG]) or usual care (control group [CG]) during an 8-weeks PR program. Prior to training, the IG completed an interview with a registered music therapist to identify music preferences. IG participants listened to an individualised playlist; CG participants had usual care. Primary outcomes included end-6-min walk test symptoms (dyspnoea and exertion) and dyspnoea (Multidimensional Dyspnoea Profile [MDP]), measured pre and post PR and 6-months follow-up. 58 participants, FEV1 52.4 (25.9)% pd) were recruited. There were no between-group differences following the intervention (<i>p</i> > .05 for all outcomes at all time points). Within-group differences following PR were significant for MDP sensory quality: IG mean difference [95% CI] -2.2 [-3.3 to -1.2]; CG -1.5 [-2.5 to -0.5] points; MDP emotional response: IG -3.2 [-4.2 to -2.3]; CG -2.2 [-3.2 to -1.3] points). Participant-selected music listening during PR offered no greater benefit to symptoms of dyspnoea or exertion compared to usual care. With the study limited by COVID-19 restrictions, the role of this adjunct remains to be clarified.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241291065"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer thank you.","authors":"","doi":"10.1177/14799731241233394","DOIUrl":"10.1177/14799731241233394","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241233394"},"PeriodicalIF":4.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A shared decision-making intervention for individuals living with chronic obstructive pulmonary disease who are considering the menu of pulmonary rehabilitation treatment options; a feasibility study.","authors":"A C Barradell,G Doe,H L Bekker,L Houchen-Wolloff,N Robertson,S J Singh","doi":"10.1177/14799731241238428","DOIUrl":"https://doi.org/10.1177/14799731241238428","url":null,"abstract":"OBJECTIVESShared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals.METHODSParticipants were recruited from Dec 2021-Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted.RESULTS13% of individuals [n = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals (n = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals' bias of centre-based PR, increased individuals' self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making.DISCUSSIONResults indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"15 1","pages":"14799731241238428"},"PeriodicalIF":4.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142179596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-pocket costs associated with chronic respiratory diseases in Korean adults.","authors":"Jun Su Park, Bomgyeol Kim, Yejin Kim, Sang Gyu Lee, Tae Hyun Kim","doi":"10.1177/14799731241233301","DOIUrl":"10.1177/14799731241233301","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic respiratory diseases (CRDs) are a burden on both individuals and society. While previous literature has highlighted the clinical burden and total costs of care, it has not addressed patients' direct payments. This study aimed to estimate the incremental healthcare costs associated with patients with CRDs, specifically out-of-pocket (OOP) costs.</p><p><strong>Methods: </strong>We used survey data from the 2019 Korea Health Panel Survey to estimate the total OOP costs of CRDs by comparing the annual hospitalizations, outpatient visits, emergency room visits, and medications of patients with and without CRDs. Generalized linear regression models controlled for differences in other characteristics between groups.</p><p><strong>Results: </strong>We identified 222 patients with CRDs, of whom 166 were aged 65 years and older. Compared with the non-CRD group, CRD patients spent more on OOP costs (238.3 USD on average). Incremental costs were driven by outpatient visits and medications, which are subject to a coinsurance of 30% or more and may include items not covered by public insurance. Moreover, CRD patients aged 50-64 years incurred the highest incremental costs.</p><p><strong>Discussion: </strong>The financial burden associated with CRDs is significant, and outpatient visits and medications constitute the largest components of OOP spending. Policymakers should introduce appropriate strategies to reduce CRD-associated burdens.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241233301"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10893827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A history of home mechanical ventilation: The past, present and future.","authors":"Rebecca F D'Cruz, Nicholas Hart","doi":"10.1177/14799731241240776","DOIUrl":"10.1177/14799731241240776","url":null,"abstract":"<p><p>This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators designed for long-term use during the poliomyelitis epidemic. Seminal data from key clinical trials supports the application of HMV in certain patients with chronic obstructive pulmonary disease, neuromuscular disease and obesity-related respiratory failure. Innovative engineering coupled with refined physiological understanding now permits widespread delivery of home mechanical ventilation to a global population, using portable devices with advanced ventilatory modes and telemonitoring capabilities. Exponential growth in digital technology continues, and ongoing research is needed to understand how to harness clinical and physiological data to benefit patients and healthcare services in a clinically- and cost-effective manner.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241240776"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140173962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent effect of the triglyceride-glucose index on all-cause mortality in critically ill patients with chronic obstructive pulmonary disease and asthma: A retrospective cohort study.","authors":"Wen-Qiang Zhou, Xin Song, Wei-Hua Dong, Zhi Chen","doi":"10.1177/14799731241245424","DOIUrl":"10.1177/14799731241245424","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The triglyceride-glucose (TyG) index serves as a reliable proxy for insulin resistance (IR). IR has been linked to heightened incidence, prevalence, or severity of chronic obstructive pulmonary disease (COPD) and asthma. Prior research indicates that critically ill patients are prone to developing IR. Nevertheless, few studies have delved into the correlation between IR and all-cause mortality in critically ill patients with COPD and asthma. Therefore, the aim of this study is to explore the association between the TyG index and all-cause mortality in patients with COPD and asthma, with the goal of assessing the impact of IR on the prognosis of this patient population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective study, and all data are from the Medical Information Mart for Intensive Care IV (MIMIC-IV) critical care database. This study included 684 ICU patients with COPD and asthma and divided them into quartiles based on TyG index levels. The primary outcomes of this study were all-cause mortality during follow-up, encompassing mortality at 30 days, 90 days, and 180 days. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality in critically ill patients with COPD and asthma. Restricted cubic spline analysis was used to assess potential nonlinear association between the TyG index and the primary outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 684 patients (53.9% female) were included. The 90-days all-cause mortality rate and 180-days all-cause mortality were 11.7% and 12.3%, respectively. Kaplan-Meier analysis revealed a significant association between the TyG index and both 90-days all-cause mortality (log-rank &lt;i&gt;p&lt;/i&gt; = .039) and 180-days all-cause mortality (log-rank &lt;i&gt;p&lt;/i&gt; = .017). Cox proportional hazards analysis revealed a significant association between the TyG index and 90-days all-cause mortality in both the unadjusted model (HR, 1.30 [95% CI 1.08-1.57] &lt;i&gt;p&lt;/i&gt; = .005) and the model adjusted for age, gender, and diabetes (HR, 1.38 [95% CI 1.15-1.67] &lt;i&gt;p&lt;/i&gt; &lt; .001). Similarly, the TyG index was associated with 180-days all-cause mortality in the unadjusted model (HR, 1.30 [95% CI 1.09-1.56] &lt;i&gt;p&lt;/i&gt; = .004) and the model adjusted for age, sex, and diabetes (HR, 1.38 [95% CI 1.15-1.66] &lt;i&gt;p&lt;/i&gt; &lt; .001). The restricted cubic splines (RCS) regression model indicated a significant nonlinear association between the TyG index and both 90-days and 180-days all-cause mortality. Specifically, TyG index &gt;4.8 was associated with an increased risk of mortality at both 90 days and 180 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In summary, our results extend the utility of the TyG index to critically ill patients with COPD and asthma. Our study shows that the TyG index is a potential predictor of all-cause mortality in critically ill patients wi","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241245424"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11015761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a respiratory and neurological rehabilitation treatment plan in post Covid-19 affected university students. Randomized clinical study.","authors":"Zacarías Sánchez Milá, David Rodríguez Sanz, Ana Martín Nieto, Ana Jiménez Lobo, Manuel Ramos Hernández, Angélica Campón Chekroun, Raúl Frutos Llanes, José Manuel Barragán Casas, Jorge Velázquez Saornil","doi":"10.1177/14799731241255967","DOIUrl":"10.1177/14799731241255967","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequelae are essential to improve respiratory function and thus quality of life, and the aim of this study is to evaluate the efficacy of a pulmonary and neurological rehabilitation program.</p><p><strong>Objectives: </strong>To apply a treatment to reduce dyspnea, increase exertional capacity, increase vital capacity and respiratory muscle strength, together with an increase in olfactory and gustatory sensitivity in post-SARS-CoV-2 patients.</p><p><strong>Methods: </strong>A randomised controlled experimental study was conducted in 220 patients with a medical diagnosis of COVID-19 and more than 5 months of evolution, dyspnoea or perceived fatigue, including olfactory and gustatory perception problems, of whom 200 patients completed the study. 100 patients were randomly assigned to the intervention group, consisting of an inspiratory training treatment plan (Powerbreathe Plus®) combined with aerobic exercise and olfactory gustatory treatment for 31 days, and 100 patients to the control group, for 31 days without any type of therapy.</p><p><strong>Results: </strong>The study was conducted in post-Covid-19 patients for 5 months. Two hundred patients were divided into an intervention group (<i>n</i> = 100) and a control group (<i>n</i> = 100). The comparison between the groups showed significant differences in spirometric variables; forced vital capacity (<i>p</i> < .001; Eta2 (0.439); Mean: 0,6135), the ratio between both FEV1/FVC (<i>p</i> < 0.01; Eta2 (0.728); Mean:9,313), peak inspiratory pressure (<i>p</i> < 0.01; Eta2 (0.906); Mean:4,526); changes were observed in dyspnoea measured with the modified Borg scale (<i>p</i> < 0.01; Eta2 (0.811); Mean:1,481) and the modified Medical Research Council scale (<i>p</i> < 0.01; Eta2 (0.881); Mean: 0.777); finally, changes were found in neurological variables, in the questions of the Singapore Smell and Taste Questionnaire, How was your sense of smell after treatment? (<i>p</i> < 0.01; Eta2 (0.813); Mean: 1,721) and How is your sense of taste after treatment? (<i>p</i> < 0.01; Eta2 (0.898); Mean: 1,088).</p><p><strong>Conclusion: </strong>The implementation of a respiratory rehabilitation treatment plan with the Powerbreathe Plus® device, aerobic exercise and neurorehabilitation with olfactory and gustatory training, is a therapeutic option against respiratory and neurological sequelae in patients who have suffered such sequelae due to the SARS-CoV-2 virus. Clinicaltrials.gov: NCT05195099. First posted 18/01/2022; Last Update Posted 29/06/2022.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241255967"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fidelity of a home-based pulmonary rehabilitation program in people with COPD referred from primary care.","authors":"Simone Dal Corso, Anne E Holland, Johnson George, Michael J Abramson, Grant Russell, Nick Zwar, Billie Bonevski, Jaycie Perryman, Narelle S Cox","doi":"10.1177/14799731241307247","DOIUrl":"10.1177/14799731241307247","url":null,"abstract":"<p><p><b>Purpose:</b> Pulmonary rehabilitation (PR) is highly effective but underutilised. Pathways to home-based PR (HBPR) from general practice could improve utilisation, but program fidelity in this setting is unknown. This study aimed to explore the fidelity of HBPR in people referred from general practice. <b>Methods:</b> Secondary analysis of intervention-group data from two-arm cluster RCT (RADICALS-interdisciplinary intervention for people with COPD including smoking cessation support, home medicine reviews and 8-weeks HBPR). HBPR fidelity assessed by the extent to which exercise training was prescribed according to protocol. Completion of HBPR and contributing factors were determined. <b>Results:</b> 107 participants (68% of intervention group) were referred to HBPR, with <i>n</i> = 75 (70%) commencing the program (mean age 68 years, FEV₁ 65% predicted, median mMRC 1). Aerobic training was prescribed according to protocol for 74% of participants in week one, and on average 89% of participants in weeks 2-8. Resistance training was prescribed according to protocol for 98% and 88% of participants (Week 1 and Weeks 2-8, respectively). Rehabilitation completers (<i>n</i> = 57, 76%) were 26 times more likely to have attended the Week 2 phone call (95% CI 2-352). Clinically meaningful improvements were achieved in health-related quality of life (SGRQ) and health status (CAT) following rehabilitation. <b>Conclusion:</b> PR program fidelity can be maintained when delivering HBPR to people with COPD referred directly from general practice. Early engagement with PR may be key to supporting rehabilitation completion.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241307247"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implications of frailty assessed in hospitalized patients with acute-exacerbation of interstitial lung disease.","authors":"Marine Van Hollebeke, Karan Chohan, Colin J Adams, Jolene H Fisher, Shane Shapera, Lee Fidler, Ewan C Goligher, Tereza Martinu, Lisa Wickerson, Sunita Mathur, Lianne G Singer, W Darlene Reid, Dmitry Rozenberg","doi":"10.1177/14799731241240786","DOIUrl":"10.1177/14799731241240786","url":null,"abstract":"<p><strong>Background: </strong>Approximately 50% of patients with interstitial lung disease (ILD) experience frailty, which remains unexplored in acute exacerbations of ILD (AE-ILD). A better understanding may help with prognostication and resource planning. We evaluated the association of frailty with clinical characteristics, physical function, hospital outcomes, and post-AE-ILD recovery.</p><p><strong>Methods: </strong>Retrospective cohort study of AE-ILD patients (01/2015-10/2019) with frailty (proportion ≥0.25) on a 30-item cumulative-deficits index. Frail and non-frail patients were compared for pre- and post-hospitalization clinical characteristics, adjusted for age, sex, and ILD diagnosis. One-year mortality, considering transplantation as a competing risk, was analysed adjusting for age, frailty, and Charlson Comorbidity Index (CCI).</p><p><strong>Results: </strong>89 AE-ILD patients were admitted (median: 67 years, 63% idiopathic pulmonary fibrosis). 31 were frail, which was associated with older age, greater CCI, lower 6-min walk distance, and decreased independence pre-hospitalization. Frail patients had more major complications (32% vs 10%, <i>p</i> = .01) and required more multidisciplinary support during hospitalization. Frailty was not associated with 1-year mortality (HR: 0.97, 95%CI: [0.45-2.10]) factoring transplantation as a competing risk.</p><p><strong>Conclusions: </strong>Frailty was associated with reduced exercise capacity, increased comorbidities and hospital complications. Identifying frailty may highlight those requiring additional multidisciplinary support, but further study is needed to explore whether frailty is modifiable with AE-ILD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241240786"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact on thirty day readmissions for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease admitted to an observation unit versus an inpatient medical unit: A retrospective observational study.","authors":"Jacob Bell, Steven Lim, Takahisa Mikami, Jeeyune Bahk, Stephen Argiro, David Steiger","doi":"10.1177/14799731241242490","DOIUrl":"10.1177/14799731241242490","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the utility of an Observation Unit (OU) in management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to identify the clinical characteristics of patients readmitted within 30-days for AECOPD following index admission to the OU or inpatient floor from the OU.</p><p><strong>Methods: </strong>This is a retrospective observational study of patients admitted from January to December 2017 for AECOPD to an OU in an urban-based tertiary care hospital. Primary outcome was rate of 30-day readmission after admission for AECOPD for patients discharged from the OU versus inpatient service after failing OU management. Regression analyses were used to define risk factors.</p><p><strong>Results: </strong>163 OU encounters from 92 unique patients were included. There was a lower readmission rate (33%) for patients converted from OU to inpatient care versus patients readmitted after direct discharge from the OU (44%). Patients with 30-day readmissions were more likely to be undomiciled, with history of congestive heart failure (CHF), pulmonary embolism (PE), or had previous admissions for AECOPD. Patients with >6 annual OU visits for AECOPD had higher rates of substance abuse, psychiatric diagnosis, and prior PE; when these patients were excluded, the 30-day readmission rate decreased to 13.5%.</p><p><strong>Conclusion: </strong>Patients admitted for AECOPD with a history of PE, CHF, prior AECOPD admissions, and socioeconomic deprivation are at higher risk of readmission and should be prioritized for direct inpatient admission. Further prospective studies should be conducted to determine the clinical impact of this approach on readmission rates.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241242490"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}