因慢性阻塞性肺病急性加重而住院的患者在观察室与住院医疗室住院三十天再入院的影响:回顾性观察研究。

IF 3.5 3区 医学 Q2 RESPIRATORY SYSTEM
Jacob Bell, Steven Lim, Takahisa Mikami, Jeeyune Bahk, Stephen Argiro, David Steiger
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引用次数: 0

摘要

研究目的我们旨在评估观察室(OU)在慢性阻塞性肺疾病(AECOPD)急性加重期管理中的效用,并确定因AECOPD入院30天内再次入院的患者的临床特征:这是一项回顾性观察研究,研究对象是2017年1月至12月期间因AECOPD入住一家城市三级医院手术室的患者。主要结果是因AECOPD入院的患者在手术室治疗失败后从手术室出院与住院服务相比的30天再入院率。回归分析用于确定风险因素:结果:共纳入92名患者的163次手术治疗。从手术室转为住院治疗的患者再入院率(33%)低于从手术室直接出院后再入院的患者(44%)。30天内再入院的患者更有可能没有户籍、有充血性心力衰竭(CHF)和肺栓塞(PE)病史,或曾因AECOPD入院。每年因AECOPD在手术室就诊超过6次的患者中,药物滥用、精神病诊断和既往肺栓塞的比例较高;排除这些患者后,30天再入院率降至13.5%:结论:因 AECOPD 入院、有 PE 病史、慢性心力衰竭、既往 AECOPD 入院史和社会经济贫困的患者再入院风险较高,应优先考虑直接住院治疗。应进一步开展前瞻性研究,以确定这种方法对再入院率的临床影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

Objectives: 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.

Methods: 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.

Results: 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%.

Conclusion: 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.

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来源期刊
Chronic Respiratory Disease
Chronic Respiratory Disease RESPIRATORY SYSTEM-
CiteScore
5.90
自引率
7.30%
发文量
47
审稿时长
11 weeks
期刊介绍: Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.
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