Factors affecting revisit of COPD exacerbated patients presenting to emergency department

Abstract

The primary purpose of this prospective cohort study was to characterize the use of the Emergency Department (ED) in patients with chronic obstructive pulmonary disease (COPD) exacerbations and determine the factors affecting the revisit of COPD patients. This is a prospective cohort study on ambulatory patients with exacerbated chronic bronchitis in an ED setting. Patients included in the study were above 18 years of age, had a previous diagnosis of COPD, and presented to the ED for the treatment of COPD exacerbation. All the information relevant to the study was collected during the patient's visit to the ED. Revisit was defined as an unscheduled visit to an ED or primary physician within 2 weeks of initial ED visit for worsening COPD symptoms. Telephone follow-up was done on all patients at the end of 2 weeks. Variables of 26 revisit cases versus 78 nonrevisit cases were compared. Home oxygen therapy, intensive care admission, previous intubation, increased cough, and the number of ED visits in the previous year were associated with increased risk of revisit in the univariate analysis. Increased cough (odds ratio: 0.232; 95% confidence interval: 0.063-0.853) and the number of ED visits in the previous year (odds ratio: 1.166; 95% confidence interval: 1.005-1.353) were still significant after multivariate analysis. In conclusion, the number of ED visits previous year and increased cough can predict the revisit of a COPD exacerbated patient within 14 days of an ED visit.

The Factors Influencing Relapse in Patients Presenting to the Emergency Department with COPD Exacerbation

“…In our previous study related to COPD and relapse, the assessment performed by using two different visual analog scales for the degree of dyspnea including the time of ED admission and of pre-discharge showed that the degree of dyspnea was not significant in predicting relapse. [2] Besides, in patients presenting to family physician and to ED due to COPD exacerbation, the severity of exacerbation might not be equal.…”

“…First group data of the study were published in ‘European Journal of Emergency Medicine’ in 2010 and approval for reuse of some of the data was received from the concerning journal. [2] Also, approval from Faculty of Medicine Research Ethics Committee was obtained for the second group data.…”

“…Although it has been reported in various studies that the patients would be presenting to hospital again in case of frequent hospital visit within previous year and increasing dyspnea, there are not any objective parameters. [2] …”

The Role of Nitric Oxide In Predicting Revisit of Patients With Exacerbated Chronic Obstructive Pulmonary Disease

“…All patients were managed at the discretion of the treating physician to better identify failure rates in real circumstances. The study protocol and data sheets were adapted from one of our previous similar studies on the revisit of COPD patients (12).…”

Factors Affecting Unscheduled Return Visits to the Emergency Department among Minor Head Injury Patients

“…The previously identified influential factors behind unscheduled ED return visits among the general patient population include older age, urgent triage level, presenting during the night shift, and certain types of initial chief complaints [ 6 – 9 ]. However, many studies have revealed that return patterns may be different among specific patient populations [ 10 – 12 ].…”