Factors Associated With Hospitalisation of Copd Exacerbations During a Winter Season In an Emergency Ward

Yıl 2021, Cilt: 48 Sayı: 2, 228 - 234, 01.06.2021

Pınar Akın Kabalak

https://doi.org/10.5798/dicletip.944321

Öz

Factors Associated With Hospitalisation of Copd Exacerbations During a Winter Season In an Emergency Ward

Öz

Objectives: Chronic obstructive pulmonary disease (COPD) is a difficult chronic illness to manage because it causes prolonged hospital admissions and repeated applications. We aimed to examine the factors affecting this situation in a winter emergency in a chest diseases emergency. Material and Method: We conducted a retrospective study in our emergency department (ED) with patients who admitted due to COPD exacerbations. Factors affecting hospitalization and ICU requirement were evaluated.
Results: Totally 128 patients were included. Mean number for ED admissions was 3.01±2.1. There were 73 (57%) hospitalized patients and 17(13.3%) patients transferred to intensive care unit (ICU). White blood cell (WBC) and C reactive protein (CRP) were significantly higher in patients with ≥3 ED admissions than others (p=0.06 and p=0.007 respectively). Among categorical variables being current smoker, long time oxygen therapy (LTOT) and non-invasive mechanical ventilation (NIMV) devices and existence of bronchiectasis were related to frequent ED admission (p=0.025, p=0.01, p=0.046 and p=0.028 respectively). Existence of pneumonia and comorbidities had positive and significant correlations with hospitalization (r=0.18, p=0.04 and r=0.26, p=0.02). In terms of ICU requirement, pneumonia, partial arterial pressure of carbon dioxide (PaCO2) value and mean pulmonary arterial pressure (PAB) had significant correlations (r=0.27, p=0.001, r=0.34, p<0.001 and r=0.24, p=0.006 respectively).
Conclusion: The correct management of the identified factors associated with recurrent emergency admission, service and ICU hospitalization in COPD patients should be done both at home and in the hospital.

Anahtar Kelimeler

COPD exacerbations, hospitalization, related factors

Kaynakça

• 1.Global Initiative for Chronic Obstructive LungDisease (GOLD). Global strategy for the diagnosis,management, and prevention of chronic obstructivepulmonary disease (2019 report) [Internet]. EUA:GOLD; 2019 [cited 2018 Dec 7]. Available from:https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf.
• 2.Zhang Y, Lin YX. Risk factors analysis for one-yearand long-term mortality in patients hospitalized foracute exacerbation of chronic obstructivepulmonary disease. Zhonghua Jie He He Hu Xi Za Zhi.2019; 42: 895-900.
• 3.Steriade AT, Davidoiu A, Afrasinei A, et al.Predictors of Long-term Mortality afterHospitalization for Severe COPD Exacerbation.Maedica (Buchar). 2019; 14: 86-92.