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VOLUME 52 , ISSUE 4 ( October-December, 2010 ) > List of Articles

Original Article

Factors Associated with Hospital Admission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Prasanta Raghab Mohapatra, Ashok Kumar Janmeja

Citation Information : Mohapatra P R, Janmeja AK. Factors Associated with Hospital Admission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Indian J Chest Dis Allied Sci 2010; 52 (4):203-206.

DOI: 10.5005/ijcdas-52-4-203

License: NA

Published Online: 10-12-2010

Copyright Statement:  NA


Abstract

Background. Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) impair quality of life (QOL), accelerate the decline in lung function and often require hospitalisation, and thus, leading to increased healthcare burden. By identifying factors that may be associated with AE-COPD and managing them rationally, not only the hospital admissions could be avoided but progression of the disease may also be slowed. Objective. The aim of the present study was to determine the factors associated with hospital admissions among adults with AE-COPD. Methods. Seventy-three patients admitted with AE-COPD were administered a structured questionnaire during their hospital stay. Data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management and outcomes during the hospitalisation were obtained. Factors associated with hospital admissions were analysed. Results. The hospitalisation due to AE-COPD was significantly associated with the reduced forced expiratory volume in one second (FEV1), and peak expiratory flow rates, increasing sputum purulence, number of hospitalisations during previous year for COPD and presence of co-morbidities. Conclusions. The study shows that both disease and healthcare-related factors are predictors for hospitalisation. Identification of risk factors and appropriate management may reduce hospitalisation due to AE-COPD.


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  1. Gudmundsson G, Gislason T, Janson C, Lindberg E, Hallin R, Ulrik CS, et al. Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J 2005;26:414-9.
  2. Garcia-Aymerich J, Monso E, Marrades RM, Escarrabill J, Félez MA, Sunyer J, et al. Risk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation. EFRAM study. Am J Respir Crit Care Med 2001;164:1002-7.
  3. Kessler R, Faller M, Fourgaut G, Mennecier B, Weitzenblum E. Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999;159:158-4.
  4. Anderson HR, Spix C, Medina S, Schouten JP, Castellsague J, Rossi G, et al. Air pollution and daily admissions for chronic obstructive pulmonary disease in 6 European cities: results from the APHEA project. Eur Respir J 1997;10:1064-71.
  5. Almagro P, Calbo E, Ochoa de Echaguen A, Barreiro B, Quintana S, Heredia JL, et al. Mortality after hospitalization for COPD. Chest 2002;121:1441-8.
  6. Connors AF Jr, Dawson NV, Thomas C, Harrell FE Jr, Desbiens N, Fulkerson WJ, et al. Outcomes following acute Factors for Hospitalisation in AE-COPD P.R. Mohapatra and A.K. Janmeja exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med 1996;154:959-67.
  7. Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al. Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 1995;98:272-7.
  8. Global Initiative for Chronic Obstructive Lung Disease strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: an Asia-Pacific perspective. Respirology 2005;10:9-17.
  9. Garcia-Aymerich J, Farrero E, Felez MA, Izquierdo J, Marrades RM, Anto JM. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax 2003;58:100-5.
  10. Miravitlles M, Guerrero T, Mayordomo C, Sanchez- Agudo L, Nicolau F, Segu JL. Factors associated with increased risk of exacerbation and hospital admission in a cohort of ambulatory COPD patients: a multiple logistic regression analysis: The EOLO Study Group. Respiration 2000;67:495-501.
  11. Roberts CM, Lowe D, Bucknall CE, Ryland I, Kelly Y, Pearson MG. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease. Thorax 2002;57:137-41.
  12. Fan VS, Curtis JR, Tu SP, McDonell MB, Fihn SD. Using quality of life to predict hospitalization and mortality in patients with obstructive lung diseases. Chest 2002;122:429-36.
  13. Godtfredsen NS, Vestbo J, Osler M, Prescott E. Risk of hospital admission for COPD following smoking cessation and reduction: a Danish population study. Thorax 2002;57:967-72.
  14. Nichol KL, Baken L, Nelson A. Relation between influenza vaccination and outpatient visits, hospitalization, and mortality in elderly persons with chronic lung disease. Ann Intern Med 1999;130:397-403.
  15. World Medical Association declaration of Helsinki. Recommendations guiding physicians in biomedical research involving human subjects. JAMA 1997;277:925-6.
  16. Jindal SK, Gupta D, Aggarwal AN. Guidelines for management of chronic obstructive pulmonary disease (COPD) in India: a guide for physicians (2003). Indian J Chest Dis Allied Sci 2004;46:137-53.
  17. Vilkman S, Keistinen T, Tuuponen T, Kivela SL. Survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital. Respiration 1997;64:281-4.
  18. Burrows B, Bloom JW, Traver GA, Cline MG. The course and prognosis of different forms of chronic airways obstruction in a sample from the general population. N Engl J Med 1987;317:1309-14.
  19. Ball P, Harris JM, Lowson D, Tillotson G, Wilson R. Acute infective exacerbations of chronic bronchitis. Q J Med 1995;88:61-8.
  20. Osman IM, Godden DJ, Friend JA, Legge JS, Douglas JG. Quality of life and hospital re-admission in patients with chronic obstructive pulmonary disease. Thorax 1997;52:67-71.
  21. Snider GL, Doctor L, Demas TA, Shaw AR. Obstructive airway disease in patients with treated pulmonary tuberculosis. Am Rev Respir Dis 1971;103:625-40.
  22. Mohan A, Premanand R, Reddy LN, Rao MH, Sharma SK, Kamity R, et al. Clinical presentation and predictors of outcome in patients with severe acute exacerbation of chronic obstructive pulmonary disease requiring admission to intensive care unit. BMC Pulm Med 2006;6:27.
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