RT Journal Article
SR Electronic
T1 Characterisation of COPD patients with long length of stay in our Acute District General Hospital
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1689
VO 44
IS Suppl 58
A1 Anita Saigal
A1 Yasser Madani
A1 Juno Sunny
A1 Leila Morris
A1 Robin Johns
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/1689.abstract
AB Introduction: Treating exacerbation accounts for the bulk of COPD healthcare expenditure. Published features associated with long Length of Stay (LoS) following admission include old age (1), extent of co-morbidity and socio-economic deprivation (2).Aims and Methods: We aimed to identify factors associated with a long LoS at Queens Hospital. According to coding data, 499 patients had a COPD admission from Dec 2012 to May 2013. Median LoS was 5 days and the 90th percentile was 14 days. Data was compared from 46 patients with a LoS around 5 days (short LoS) and 52 patients with a LoS above 14 days (long LoS).Results: In comparison to short LoS, long LoS was associated with: a higher PaCO2 (7.2 vs 5.6 kPa, p<0.01), higher HCO3 (29 vs 25 mM, p=0.01), higher WCC (13 vs 11 x 109/L, p=0.05), higher CRP (71 vs 41, p=0.05), lower albumin (36 vs 38 g/L, p=0.05), and lower Braden score (18 vs 20, p=0.04). In addition, Long LoS patients more frequently had carers at home prior to admission (40% vs 26%), and required new social care or care home placement on discharge (28% vs 6%).Discussion: Although differences in biochemical and physiological parameters are associated with long LoS, other very important associations are the need for social support prior to admission and for new social support on discharge. Our hospital COPD population is elderly (Mean age 78 vs 71 in the UK COPD national audit (1)), with extensive co-morbidity, and high levels of socio-economic deprivation. Complex discharge planning will increasingly be a key aspect of hospital COPD management for all as the population ages.(1) Price LC et al, Thorax 2006, 61: 837-842; (2) Agboado G et al, BMJ Open 2012, 2: e000869.