%0 Journal Article %A Daniel Franzen %A Franziska Graf %A Stephan Wieser %A Swantje Beyer %A Thomas Hess %A Nina Badertscher %A Kaba Della Lana %A Malcolm Kohler %A Oliver Senn %A Claudia Steurer-Stey %T Hospital care patterns in the management of acute exacerbated chronic obstructive pulmonary disease - A retrospective analysis from Zurich, Switzerland %D 2014 %J European Respiratory Journal %P P795 %V 44 %N Suppl 58 %X BackgroundDifferences in patient outcomes of acute exacerbated COPD (AECOPD) exist. These are at least in part linked to non-adherence to recommendations.MethodsRetrospective medical chart review of patients with AECOPD in 3 public hospitals in the canton of Zurich between January and December 2012 to evaluate the implentation of treatment recommendations.ResultsData from 94 patients (56% male, mean age 69.3 years) were analyzed. Mean hospital stay was 8.9 days. GOLD grading was documented in 85%, of these 59% were in GOLD stage III/IV. One or more previous AECOPD hospitalizations were reported in 30% and comorbidities in 64% (hypertension 49%, cardiac disease 25%, diabetes 16%, and depression 17%). Treatment of AECOPD included antibiotics in 79%, systemic corticosteroids in 76% and combination of both in 60%. Documentation of non-pharmacological performance measures were as follows: Smoking cessation advice (41%), influenza vaccination or recommendation (22%), instruction in inhalation technique (17%), advice for physical activity/pulmonary rehabilitation (5%), referral to pulmonary rehabilitation (17 %). Instruction in exacerbation management or a written action plan was never documented. Follow-up appointment and coordination of care prior to discharge was documented with GP (93%), pulmonary specialist (37%), lung league (23%), pulmonary rehabilitation centers (17%), and physiotherapists (16%).ConclusionGaps between recommended care and documented performance measures in patients hospitalized with AECOPD exist. The identified gaps can be targeted by linking the results to quality improvement interventions. %U