COPD patients in the northern suburbs of the Western Cape Metropole hospitalised due to acute exacerbation : baseline study

[摘要] ENGLISH ABSTRACT: Acute exacerbation is an important event of COPD as it causes significant disability andmortality. Especially repeated hospitalisation of patients with acute exacerbation has beenassociated with reduce quality of life and excessive hospitalisation cost. Chronic ObstructivePulmonary Disease causes significant functional limitations that translate into enormouseconomic and societal burden.Study Aim: To describe the profile and selected outcomes of Chronic Obstructive PulmonaryDisease (COPD) patients admitted with acute exacerbation to hospitals in the northernsuburbs of the Western Cape.Study design: A multicenter retrospective descriptive single subject design was used.Method: Patients admitted with the diagnosis of COPD with acute exacerbation in the timeperiod 01June 2004-01June 2005 were followed up retrospectively for a period of 12 months.The demographics, medical condition on admission and past presentation of acuteexacerbation, length of stay in hospital and the number of readmissions for acuteexacerbation in the 12 month period were collected and recorded on a self designed datacapture sheet.Results: One hundred and seventy eight patients were admitted with acute exacerbation atthe three hospitals. The mean age of the patients were 63 (±11.73), more males than females(103: 75) were admitted. Subjects spent a mean of 5.67 (±6.55), days in hospital with every admission and admission frequency of up to eight periods were recorded. Of the n=178admitted, 56% had one admission and 44% had 2 or more admissions in the study year. Thisresulted in a total of 338 hospital admissions with the 78 subjects responsible for the majorityof admissions (238) Subjects presenting with two or more co-morbidities had a significantlygreater risk of multiple re admissions. Subjects with three or more admissions had two ormore co morbidities (p=0.001), comparatively those with one admission had only one comorbidity. Congestive cardiac failure (p=0.01) as well as the lack of Long Term OxygenTherapy p=0.017) were associated with increase risk of three or more admissions.Conclusion: Patients admitted with acute exacerbation to the hospitals where the study wasconducted presented with an age ranging from 30-95 years. Patients with 2 or moreadmissions experience up to eight readmissions episodes in the study year. This is a cause ofconcern in respect of the burden of disease on especially the younger economically viableSouth African population. In the current study factors that influenced readmission were thepresence of two or more co morbid diseases, specifically the presence of congestive cardiacfailure as well as the lack of LTOT. Interventions including a pulmonary rehabilitationprogramme post discharge should be aimed at decreasing frequency of hospitalisationespecially in those patients who are a risk of readmission.

[发布机构] Stellenbosch University