Factors associated with the incidence of serious adverse events in patients admitted with COPD acute exacerbation

García-Sanz, María-Teresa; Cánive-Gómez, Juan-Carlos; García-Couceiro, Nuria; Senín-Rial, Laura; Alonso-Acuña, Sara; Barreiro-García, Alejandra; López-Val, Eva; Valdés, Luis; González‐Barcala, Francisco‐Javier

doi:10.1007/s11845-016-1431-9

Cited by 7 publications

(7 citation statements)

References 40 publications

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“…The large number of comorbidities in COPD patients significantly influenced the health care system that included health-related quality of life, resource consumption, and short-term prognosis [ 4 , 5 ]. In this study, arrhythmias and DM were factors that increased the risk for treatment failure which were quite similar with previous studies [ 4 , 11 , 16 , 17 ]. Sin et al reported that cardiovascular disease including arrhythmias led to hospitalization of COPD patients, and arrhythmias was associated with higher in-hospital mortality [ 16 ].…”

Section: Discussionsupporting

confidence: 91%

“…This study showed that SABA use as the baseline treatment was related with treatment failure in AECOPD patients. This result was similar to a study by García-Sanz et al which demonstrated that anticholinergic therapy as baseline treatment was associated with a higher incidence of serious adverse events in patients with AECOPD [ 11 ]. Also, Garcia-Aymerich said taking anticholinergics was related to an increased risk of readmission [ 12 ].…”

Section: Discussionsupporting

confidence: 91%

“…A previous study reported an association between the use of long-term oxygen therapy at home and a higher risk of readmission and death in patients with AECOPD which was similar to this current study [1,4,11,24,25]. Patients with COPD who require constant oxygen therapy at home have limited movement and exercise ability which might affect morbidity and mortality [12].…”

Section: Discussionsupporting

confidence: 86%

“…Previous studies evaluated factors associated with adverse outcomes in hospitalized patients with AECOPD [4,11,12]. Some studies evaluated the factors associated with hospitalization of AECOPD patients in the ED [13].…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Pethyabarn

Chewae

Dadeh

2020

Emergency Medicine International

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Objective. We aimed to identify factors associated with treatment failure in patients with acute exacerbation of COPD (AECOPD) admitted to the emergency department observation unit (EDOU). Methods. A retrospective cohort study was conducted between January 1, 2013, and October 31, 2019. The electronic medical records were reviewed of patients with AECOPD admitted to the EDOU. The patients were divided into treatment failure and treatment success groups. Treatment failure was defined as prolonged stay at the EDOU (>48 h) or COPD-related ED revisit (within 72 h) or readmission within 1 month. The two groups were compared and analyzed using univariable and multivariable analyses by logistic regression. Results. Of the 220 patients enrolled, 82 (37.3%) developed treatment failure. Factors associated with treatment failure included arrhythmias (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.04–13.9), diabetic mellitus (OR 2.32, 95% CI 1.09–4.95), long-term oxygen therapy (OR 2.89, 95% CI 1.08–7.72), short-acting beta-agonist use (OR 6.06, 95% CI 1.98–18.62), pneumonia findings on chest X-ray (OR 3.24, 95% CI 1.06–9.95), and ED length of stay less than 4 h (OR 2, 95% CI 1.08–3.73). Conclusion. Arrhythmias, diabetic mellitus, long-term oxygen therapy, short-acting beta-agonist use, pneumonia findings on chest X-ray, and ED length of stay <4 h were the significant factors associated with treatment failure of AECOPD to which physicians at the ED should pay special attention before the admission of patients to the EDOU.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Pethyabarn

Chewae

Dadeh

2020

Emergency Medicine International

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“…In the present study, the clinical outcomes of COPD exacerbation exhibited risk factors or predictive factors similar to other studies171819. Current smokers were less likely to be admitted to the ICU than ex-smokers or non-smokers.…”

Section: Discussionsupporting

confidence: 84%

Utility of Computed Tomography in a Differential Diagnosis for the Patients with an Initial Diagnosis of Chronic Obstructive Pulmonary Disease Exacerbation

Park

Kim

et al. 2019

Tuberc Respir Dis

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Background The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6–13] days vs. 8 [6–12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

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Establishing the Prognosis of COPD Exacerbations Using Risk Scales from the Point of View of the Emergency Department

Sanz¹,

Barcala

2020

Archivos de Bronconeumología (English Edition)

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Factors associated with the incidence of serious adverse events in patients admitted with COPD acute exacerbation

Abstract: Oxygen therapy at home, anticholinergic therapy as baseline treatment, lower oxygen saturation at admission and lower serum albumin level seem to be associated with higher incidence of SAE in patients with AECOPD.

Cited by 7 publications

References 40 publications

Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Factors Associated with Treatment Failure in Patients with Acute Exacerbation of COPD Admitted to the Emergency Department Observation Unit

Utility of Computed Tomography in a Differential Diagnosis for the Patients with an Initial Diagnosis of Chronic Obstructive Pulmonary Disease Exacerbation

Establishing the Prognosis of COPD Exacerbations Using Risk Scales from the Point of View of the Emergency Department

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