Factors Influencing the Length of Hospital Stay Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in Macao Population: A Retrospective Study of Inpatient Health Record

Abstract

This study aims to identify the effects of patient and clinical therapy factors on the length of hospital stay (LOS) for admission due to chronic obstructive pulmonary disease (COPD) in Macao. Patients and Methods: Health record of patients with COPD admitted to Kiang Wu Hospital from January 2017 to December 2019 was retrospectively analyzed. Demographic information, blood test results, clinical therapies, and LOS were described and analyzed by multivariable regression. Results: A total of 1116 admissions were included with the average LOS being 12.28 (±9.23) days. Among them, 735 (66.6%) were male with mean age 79.42 (±10.35) years old, 697 were current or previous smokers (62.5%), and 360 (32.2%) had 3 or more comorbidities. During hospitalization, the most common treatments received were oxygen therapy (n=991,88.8%), antibiotics (n=828,74.2%), and systemic steroids (n=596,53.4%); only 120 (10.8%) had pulmonary rehabilitation (PR) and 128 (11.5%) received noninvasive ventilation (NIV). Inhaled medications were used during nearly 95% of hospitalization cases, while 2 and 3 types of inhaled medications were used during 230 (20.6%) and 582 (52.2%) hospitalization cases, respectively. Patient factors including age (B=0.

Factors affecting length of hospital stay in chronic obstructive pulmonary disease patients in a tertiary hospital of Nepal: A retrospective cross-sectional study

“…Our study showed a significant association between length of stay with the number of comorbidities COPD patients were having at admission. Four out of five COPD inpatients in this study had at least one comorbidity, which was similar to previous studies [ 8 , 14 , 15 ]. A similar association has been established by various studies, thus reaffirming comorbidities as an important predictor of prolonged hospitalization [ 10 , [16] , [17] , [18] , [19] ].…”

“…Moreover, the length of stay was significantly associated with the use of mechanical ventilatory support for the COPD patients during the inpatient stay. Similarly, an association between inpatient stay and mechanical ventilation has been seen in studies from India and Macau [ 8 , 27 ]. The study of Lindenauer et al showed that COPD patients treated with noninvasive ventilation at the time of hospitalization had lower inpatient mortality, shorter length of stay, and lower costs compared with those treated with IMV [ 28 ].…”

“…Studies from different countries have shown considerable heterogeneity and geographical variation in the length of stay in COPD patients. The length of hospital stay in COPD patients is variable throughout the world, ranging from 11.64 days in the USA, 6–7 days in European countries, 7.8 days in Australia, 5 days in Hongkong, 9.38 days in China and 12.28 days in Macao [ 7 , 8 , [10] , [11] , [12] , [13] ]. Therefore, on comparing these, the LOS of COPD patients is similar to that in European countries and Australia.…”

“…Hospitalization for acute exacerbation of COPD is recognized as a major event due to its negative effect on lung function, survival, risk of readmission, and quality of life [ 5 , 6 ]. The length of stay (LOS) in COPD patients is variable, ranging from 5 to 12 days [ 7 , 8 ]. Common factors associated with prolonged stay are older age, comorbidities, and socioeconomic deprivation.…”

Clinical and Non-Clinical Predictors of Length of Stay in Indonesian hospitalized COPD (Chronic Obstructive Pulmonary Disease) Patients

“…Older COPD patients generally have a higher risk of acute exacerbations, leading to increased LOS. The prevalence of COPD in older patients has a negative impact on the length of stay (Li et al, 2021). The results of research conducted by Agboado et al (2012) found a significant increase in the LOS of patients aged 80 years and over compared to patients aged 40-59 years.…”