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Copd readmission

Rainer Gloeckl
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common condition that is becoming increasingly prevalent. It affects 13.2% of the population over age 40 in Germany. In 2020, it will be the third most common cause of morbidity and mortality around the world. It markedly impairs the quality of life of those who suffer from it and presents a major economic challenge to the health-care system. METHODS: This review is based on pertinent publications retrieved by a selective literature search and on the authors' clinical experience...
February 23, 2018: Deutsches Ärzteblatt International
Arora R Ingadottir, Anne M Beck, Christine Baldwin, C Elizabeth Weekes, Olof G Geirsdottir, Alfons Ramel, Thorarinn Gislason, Ingibjorg Gunnarsdottir
Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016)...
March 2018: British Journal of Nutrition
Karine Luz Londoño, Francesc Formiga, David Chivite, Rafael Moreno-Gonzalez, Margherita Migone De Amicis, Xavier Corbella
Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in heart failure (HF) patients. Whether a prior COPD diagnosis influences patients' prognosis in early stages of HF is unknown. We reviewed patients > 50 years old admitted because of a first episode of acute HF. We divided the sample into two groups according to the existence of a prior diagnosis of COPD. We used regression analysis to identify the baseline patients' characteristics associated with the presence of COPD, and Cox mortality analysis to identify baseline and discharge data related to higher risk of a combined outcome of 1-year all-cause readmission or mortality...
March 6, 2018: Internal and Emergency Medicine
Danny Epstein, Roni Nasser, Tanya Mashiach, Zaher S Azzam, Gidon Berger
BACKGROUND: Acute exacerbation of COPD (AECOPD) is one of the leading causes for hospitalization and readmission in developed countries. No laboratory indices were consistently found to be associated with readmission risk. Recent evidence attests that red blood cell distribution width (RDW), conveys important information for short and long term prognosis in a variety of medical conditions. Prognostic usefulness of RDW in patients with AECOPD has not been investigated. OBJECTIVE: To evaluate the usefulness of RDW in predicting early adverse outcomes in patients hospitalized due to AECOPD...
March 2018: Respiratory Medicine
Faisal Aziz, Erik B Lehman
OBJECTIVES: Readmissions after surgical procedures are increasingly considered a metric to indicate the quality of care received during the index hospitalization. Patients with peripheral arterial disease requiring Peripheral Vascular Interventions (PVI) or Lower Extremity Bypasses (LEB) often have several serious medical comorbidities. Risk factors associated with readmission after PVI and LEB have previously been identified. The purpose of this study is to compare the readmissions among patients receiving PVI and LEB procedures to identify risk factors associated with high risk of readmission...
February 23, 2018: Annals of Vascular Surgery
Lori A Gurien, Joseph J Tepas, D Scott Lind, David J Chesire, Michel J Sabra, Brian Ga Dalton, Ziad T Awad
BACKGROUND: Recent data suggest that surgical outcomes at hospitals caring for low-income, vulnerable populations are suboptimal compared to non safety net hospitals. Therefore, the purpose of our study was to compare outcomes for patients who underwent an Ivor-Lewis esophagectomy at a safety net hospital with the National Surgical Quality Improvement Program (NSQIP) database. STUDY DESIGN: We retrospectively reviewed the medical records of consecutive patients who underwent an Ivor-Lewis esophagectomy from September 2013 to January 2017 at a single safety net hospital...
January 21, 2018: Journal of the American College of Surgeons
Deborah Seys, Luk Bruyneel, Walter Sermeus, Cathy Lodewijckx, Marc Decramer, Svin Deneckere, Massimiliano Panella, Kris Vanhaecht
This study aimed to increase our understanding of processes that underlie the effect of care pathway implementation on reduced 30-day readmission rate. Adherence to evidence-based recommendations, teamwork and burnout have previously been identified as potential mechanisms in this association. We conducted a secondary data analysis of 257 patients admitted with chronic obstructive pulmonary disease exacerbation and 284 team members caring for these patients in 19 Belgian, Italian and Portuguese hospitals. Clinical measures included 30-day readmission and adherence to a specific set of five care activities...
February 20, 2018: COPD
Alicia Cerezo Lajas, Enrique Gutiérrez González, César Llorente Parrado, Luis Puente Maestu, Javier de Miguel-Díez
OBJECTIVES: To compare characteristics of patients readmitted after discharge by chronic obstructive pulmonary disease (COPD) exacerbation with those who were not readmitted and to identify factors associated with readmission risk. PATIENTS AND METHODS: We randomly selected a group of 40 COPD patients with high frequency of readmissions (HFR), who had ≥ 2 admissions by COPD exacerbation within 30 days after the last admission in 2015, and another group of 40 COPD patients with low frequency of readmissions (LFR), with 0-1 admissions in that period...
February 14, 2018: Lung
Elizabeth Broadbent, Jeff Garrett, Nicola Jepsen, Vickie Li Ogilvie, Ho Seok Ahn, Hayley Robinson, Kathryn Peri, Ngaire Kerse, Paul Rouse, Avinesh Pillai, Bruce MacDonald
BACKGROUND: Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD). Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization. OBJECTIVE: This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group...
February 13, 2018: Journal of Medical Internet Research
Mette Jørgensen, Jan Mainz, Peter Lange, Søren Paaske Johnsen
Objective: To examine the association between schizophrenia and the quality of care and clinical outcomes of chronic obstructive pulmonary disease (COPD). Design: A Danish nationwide population-based cohort study using comprehensive information from Danish registries between 2008 and 2013. Setting: Public Danish hospitals. Participants: 72 692 COPD patients with hospital contacts including 621 with schizophrenia. Intervention: COPD care...
February 8, 2018: International Journal for Quality in Health Care
Mary Jane Genuino
The 2014 national percentage for 30-day readmissions among Medicare recipients from Post-Acute Care Unit (PACU) showed: Heart Failure (HF) with major complications and co-morbidities, an average of 24.09%, and Chronic Obstructive Pulmonary Disease (COPD) with complications and co-morbidities 23.12%. The percentage of readmissions for New Jersey among PACU showed: HF with major complications and co-morbidities, an average of 24.40% and COPD 26.35% (Avalere Health, 2014). For this study site, the hospital readmission rate was not specifically broken down according to condition/diagnosis...
February 2018: Applied Nursing Research: ANR
Derek N Bremmer, Briana E DiSilvio, Crystal Hammer, Moeezullah Beg, Swati Vishwanathan, Daniel Speredelozzi, Matthew A Moffa, Kurt Hu, Rasha Abdulmassih, Jina T Makadia, Rikinder Sandhu, Mouhib Naddour, Noreen H Chan-Tompkins, Tamara L Trienski, Courtney Watson, Terrence J Obringer, Jim Kuzyck, Thomas L Walsh
BACKGROUND: Antibiotics are often prescribed for hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations. The use of procalcitonin (PCT) in the management of pneumonia has safely reduced antibiotic durations, but limited data on the impact of PCT guidance on the management of COPD exacerbations remain. OBJECTIVE: To determine the impact of PCT guidance on antibiotic utilization for hospitalized adults with exacerbations of COPD. DESIGN: A retrospective, pre-/post-intervention cohort study was conducted to compare the management of patients admitted with COPD exacerbations before and after implementation of PCT guidance...
February 5, 2018: Journal of General Internal Medicine
George A Yakubek, Gannon L Curtis, Nipun Sodhi, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Specifically, we asked the following questions: (1) Is COPD associated with adverse perioperative outcomes and (2) Does COPD increase the risk of short-term complications following THA? METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 64,796 patients who underwent THA between 2008 and 2014...
January 9, 2018: Journal of Arthroplasty
Xavier Serra-Picamal, Ramon Roman, Joan Escarrabill, Anna García-Altés, Josep Maria Argimón, Nestor Soler, Rosa Faner, Elisenda Martinez Carbonell, Antoni Trilla, Alvar Agusti
BACKGROUND: Patients with Chronic Obstructive Pulmonary Disease (COPD) may suffer episodes of exacerbation (ECOPD) that require hospitalization and worsen their health status, and prognosis. We hypothesized that a detailed interrogation of health-care "big data" databases can provide valuable information to better understand the risk factors and outcomes of these episodes. MATERIAL AND METHODS: We interrogated four databases of the Catalan health-care system (>8,000,000 registries) to identify patients hospitalized because of ECOPD for the first time (index event) between 2010 and 2012...
January 16, 2018: Respiratory Medicine
Lianping Yang, Chaojie Liu, Cunrui Huang, Dana B Mukamel
BACKGROUND: Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. METHODS: We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest...
January 29, 2018: BMC Health Services Research
Farhan Zaidi, Ryan S Lee, Bartosz A Buchcic, Nina E Bracken, H Ari Jaffe, Min Joo, Valentin Prieto-Centurion, Ai-Yui Tan, Jerry A Krishnan
Rationale: Patients hospitalized with chronic obstructive pulmonary disease (COPD) who require supplemental oxygen (O2) are at increased risk of hospital readmissions. There is a paucity of information regarding quality of evaluation and documentation regarding the need for supplemental O2 in this population.  Objective: To determine the extent to which evaluation and documentation regarding the need for supplemental O2 occurs prior to hospital discharge in patients with COPD.  Methods: We conducted a two-center retrospective cohort study of hospitalized adults with a physician diagnosis of COPD...
September 20, 2017: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Gary T Ferguson, Bonnie Beck, Emmanuelle Clerisme-Beaty, Dacheng Liu, Byron M Thomashow, Robert A Wise, Richard ZuWallack, Barry J Make
Background: Hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with increased mortality and decreased quality of life. Replicate hospital discharge studies were initiated to examine efficacy and safety of once-daily tiotropium HandiHaler® versus placebo, in addition to usual care, in patients discharged from the hospital after an AECOPD. Methods: Both studies were randomized, placebo-controlled, double-blind, parallel-group, multicenter, with inclusion/exclusion criteria providing a diverse COPD patient cohort hospitalized for ≤14 days with AECOPD...
August 10, 2017: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
Michael E Rezaee, Charlotte E Ward, Bonita Nuanez, Daniel A Rezaee, Jeffrey Ditkoff, Alexandra Halalau
Background: Thirty-day readmission in COPD is common and costly, but potentially preventable. The emergency department (ED) may be a setting for COPD readmission reduction efforts. Objective: To better understand COPD readmission through the ED, ascertain factors associated with 30-day readmission through the ED, and identify subgroups of patients with COPD for readmission reduction interventions. Patients and methods: A retrospective cohort study was conducted from January 2009 to September 2015 in patients with COPD of age ≥18 years...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Charlotte Lloyd, Joanne Garside
Chronic obstructive pulmonary disease (COPD), the umbrella term used to describe chronic lung diseases that cause limitations in lung airflow, is predicted to be the third leading cause of death by 2030. COPD is said to affect 3 million people in the UK, resulting in approximately 30 000 deaths each year. Related healthcare costs continue to escalate, not least because of increasing readmission rates associated with COPD emergencies. The use of care bundles to streamline care is becoming more popular in an attempt to tackle this issue...
January 11, 2018: British Journal of Nursing: BJN
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