Home Intervention and Predictor Variables for Rehospitalization in Chronic Obstructive Pulmonary Disease Exacerbations

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• 作者：Bernabé ; Jurado Gá ; mez^a ; ^{bjg01co@hotmail.com} ; Nuria Feu Collado^a ; José ; Carlos Jurado Garcí ; a^b ; Francisco Garcí ; a Gí ; l^a ; Elisa Mu&#241 ; oz Gomariz^c ; Luis Jimé ; nez Murillo^d ; Luis Mu&#241 ; oz Cabrera^a
• 关键词：Chronic obstructive pulmonary disease ; Chronic obstructive pulmonary disease exacerbation ; Hypercapnia ; Predictors of readmission ; Readmission risk
• 刊名：Archivos de Bronconeumología (English Edition)
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：49
• 期：1
• 页码：10-14
• 全文大小：329 K

文摘

Background

Chronic obstructive pulmonary disease (COPD) exacerbation increases mortality and resources used associated with hospitalization. We studied whether early home monitoring reduces the rate of readmission and if there are any predictor variables.

Patients and methods

We performed a prospective, controlled, parallel-group study in patients who were hospitalized for COPD. Patients whose residence was within less than 15 km from the hospital were assigned to an interventional group (home visits by nurses about 48-72 h after discharge), the remaining patients were assigned to a conventional care group. The rate of rehospitalization within the first month was compared between the 2 groups, as well as those variables that showed a predictive capability.

Results

Seventy-one patients were included: 35 in the conventional care group and 36 in the interventional group. In the latter, the treatment was modified in 13 patients (36 % ). The hospital readmission rate was 17 % , which was similar in both groups (P=.50). For every 5-year increase in age, the risk for readmission was 2.54 (95 % CI 1.06-5.07) and for each increase of 10 mmHg in PaCO₂, the risk of readmission was 8.34 (95 % CI 2.43-18.55).

Conclusions

Early home monitoring did not decrease the readmission rate during the first month. Older age and high PaCO₂ are factors that identify the group with a high risk for rehospitalization.