RESUMO
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Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/terapia , Recidiva , Hospitalização/estatística & dados numéricos , Tratamento de Emergência/métodos , Pneumonia/complicaçõesRESUMO
Fundamento y objetivo: Las exacerbaciones de la enfermedad pulmonar obstructiva crónica (EA-EPOC) constituyen un factor determinante en el deterioro de los pacientes, con gran repercusión sobre el gasto sanitario. El objetivo de este estudio fue evaluar el impacto de la atención de las EA-EPOC en un hospital de día de enfermedades respiratorias (HDER) sobre la tasa de ingresos hospitalarios. Pacientes y método:Durante 14 meses se recogieron prospectivamente todos los episodios de EA-EPOC atendidos en el HDER y en el Servicio de Urgencias, excluyendo a los pacientes con otra causa de agudización o necesidad de ventilación mecánica invasiva.Resultados: Se incluyeron 226 episodios (173 pacientes, edad media [DE] de 72 [8] años). En el HDER se atendieron 121 (53,5%). El número de ingresos en el grupo del HDER fue claramente inferior (32,2 frente a 66,7%, p<0,001), incluso en pacientes con más ingresos el año previo. No hubo diferencias en la gravedad de la exacerbación ni en la tasa de reingresos ni de mortalidad en el seguimiento.Conclusiones: El manejo de las EA-EPOC en el HDER parece reducir el número de ingresos hospitalarios en comparación con un Servicio de Urgencias (AU)
Background and objective: Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) are considered to be the most important factor in determining the course of the disease, and have great impact on the health care system. We evaluated the effects of a Respiratory Day Hospital (RDH) on the rate of hospital admissions due to AE-COPD. Patients and methods:During 14 months, every case of AE-COPD seen at the RDH and emergency services was recruited prospectively. Patients were excluded when another known cause of exacerbation was present and/or when they required invasive mechanical ventilation. Results:226 episodes (173 patients) were included (72, SD 8years old). One hundred and twenty one cases received treatment at the RDH (53.5%). Admissions from the RDH group were noticeably lower (32.2 vs. 66.7%, p<0.001), even in patients with more admissions due to AE-COPD the year before the study. There were no differences either in terms of AE-COPD severity or in readmissions and mortality rates during the follow up.Conclusions: Management of AE-COPD in a RDH seems to be associated with a lower rate of hospital admissions in comparison with an emergency department (AU)
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , /estatística & dados numéricos , Hospital Dia , Recidiva , Tratamento de Emergência/estatística & dados numéricosRESUMO
BACKGROUND AND OBJECTIVE: Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) are considered to be the most important factor in determining the course of the disease, and have great impact on the health care system. We evaluated the effects of a Respiratory Day Hospital (RDH) on the rate of hospital admissions due to AE-COPD. PATIENTS AND METHODS: During 14 months, every case of AE-COPD seen at the RDH and emergency services was recruited prospectively. Patients were excluded when another known cause of exacerbation was present and/or when they required invasive mechanical ventilation. RESULTS: 226 episodes (173 patients) were included (72, SD 8 years old). One hundred and twenty one cases received treatment at the RDH (53.5%). Admissions from the RDH group were noticeably lower (32.2 vs. 66.7%, p<0.001), even in patients with more admissions due to AE-COPD the year before the study. There were no differences either in terms of AE-COPD severity or in readmissions and mortality rates during the follow up. CONCLUSIONS: Management of AE-COPD in a RDH seems to be associated with a lower rate of hospital admissions in comparison with an emergency department.
