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Mortality and readmissions in patients with acute exacerbation of chronic obstructive pulmonary disease treated at a specialised pulmonary ward and general wards.
Dan Med J. 2014 Oct;61(10):A4938
Authors: Zacho Priess Leere M, Møller Weinreich U
Abstract
INTRODUCTION: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the most common cause of admission to medical wards. In Denmark, patients are often referred to general medical wards, e.g. departments of internal medicine (IM), and only a minority are admitted to highly specialised units such as departments of pulmonary diseases (DPD).
MATERIAL AND METHODS: This retrospective study investigated the risk of readmission 12 months after primary admission in 136 patients admitted to either IM or DPD due to AECOPD. Furthermore, mortality 18 months after primary admission was investigated. A subanalysis was made for patients receiving non-invasive ventilation and for patients with telehealthcare. Data were obtained from patients' case records.
RESULTS: There was no difference in readmission in patients' primary admission at DPD versus IM. The median number of readmissions for patients participating in telehealthcare was four compared with two in patients who did not (p = 0.026). In-hospital mortality during primary admission was significantly higher at DPD than at IM (relative risk (RR) = 3.54; p = 0.047). Telehealthcare participation was associated with a trend towards a lower mortality. Mortality was significantly higher in patients receiving non-invasive ventilation than in patients at DPD who did not receive non-invasive ventilation at their primary admission (RR = 5.02; p = 0.011).
CONCLUSION: There was no difference in the risk of readmission in patients admitted to DPD and IM, respectively. Patients assigned to telehealthcare did not have a higher readmission rate, but those who were readmitted were readmitted more times (p = 0.026).
FUNDING: not relevant.
TRIAL REGISTRATION: This trial was registered with the Danish Data Protection Agency (J. no. 2008-58-0028).
PMID: 25283625 [PubMed - indexed for MEDLINE]