RT Journal Article
SR Electronic
T1 Home care in patients hospitalized for exacerbation of COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3789
DO 10.1183/13993003.congress-2016.PA3789
VO 48
IS suppl 60
A1 Villar Alvarez, Felipe
A1 Sánchez Mellado, Diana
A1 Fernández Ormaechea, Itziar
A1 Álvarez Suárez, Laura
A1 Checa Venegas, María José
A1 Armenta Fernández, Rebeca
A1 Gómez del Pulgar Murcia, María Teresa
A1 Cabezas Pastor, Elena
A1 Giménez Velando, Andrés
A1 Peces-Barba Romero, Germán
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3789.abstract
AB INTRODUCTION: With the objective of reducing the rate of readmissions of discharged for COPD exacerbation, our chronic outpatient respiratory care unit (UCCRA) was created.METHODS: Observational study in which we compared data of patient included in UCCRA from January to October 2015 with patients with not home care, and with the patients included in UCCRA in the same period in 2014 with only telephone follow-up. Patients were admitted in UCCRA if they fit our criteria, based on our Readmission Risk Scale (RRS) that incorporates these variables: age, exacerbations (hospitalization or not) in the last year, FEV1, bacterial colonization, chronic bronchitis, Karnofsky index and cardiovascular comorbidity. Patients were included in UCCRA if they had suffered > 2 hospitalizations in the last year or > 7 points in our RRS.RESULTS: We included 399 patients, 234 patients were discharged after an exacerbation of COPD in 2015, with a mean age (MA) of 71.8 years, mean stay (MS) of 7.4 days and 13.3% of readmissions. 108 were included in UCCRA, who had significantly higher MS and previous exacerbations, reduced FEV1 and Karnofsky, and higher percentage of readmissions than not included (22.2 vs 6.3%). Patients with home care in 2015, compared with 2014 with telephone follow-up (165 patients, MA: 72.6, MS: 6.2), had more previous non-hospital exacerbations (p <0.05) and less readmissions (13.6 vs 19.3%, p 0.06). UCCRA patients in 2015 had significantly less previous hospitalizations and fewer readmissions than those of UCCRA in 2014 (22.2 vs 50%).CONCLUSIONS: UCCRA with home care was valid to reduce readmissions in COPD patients, compared with telephone follow-up. Previous hospitalizations was the variable that better predict readmission.