BACKGROUND:Chronic obstructive pulmonary disease (COPD) exacerbation increases mortality and resources used associated with hospitalization. We studied whether early home monitoring reduces the rate of readmission and if there are any predictor variables. PATIENTS AND METHODS: We performed a prospective, controlled, parallel-group study in patients who were hospitalized for COPD. Patients whose residence was within less than 15km from the hospital were assigned to an interventional group (home visits by nurses about 48-72hours after discharge), the remainder were assigned to a conventional care group. The rate of rehospitalization within the first month was compared between the two groups, as well as those variables that showed a predictive capability. RESULTS:Seventy one patients were included: 35 in the conventional care group and 36 in the interventional group. In the latter, the treatment was modified in 13 patients (36%). The hospital readmission rate was 17%, which was similar in both groups (P=.50). For every 5-year increase in age, the risk for readmission was 2.54 (95%CI, 1.06-5.07) and for each increase of 10mmHg in PaCO(2), the risk of readmission was 8.34 (95%CI, 2.43-18.55). CONCLUSIONS: Early home monitoring did not decrease the readmission rate during the first month. Older age and high PaCO(2) are factors that identify the group with a high risk for rehospitalization.
RCT Entities:
BACKGROUND:Chronic obstructive pulmonary disease (COPD) exacerbation increases mortality and resources used associated with hospitalization. We studied whether early home monitoring reduces the rate of readmission and if there are any predictor variables. PATIENTS AND METHODS: We performed a prospective, controlled, parallel-group study in patients who were hospitalized for COPD. Patients whose residence was within less than 15km from the hospital were assigned to an interventional group (home visits by nurses about 48-72hours after discharge), the remainder were assigned to a conventional care group. The rate of rehospitalization within the first month was compared between the two groups, as well as those variables that showed a predictive capability. RESULTS: Seventy one patients were included: 35 in the conventional care group and 36 in the interventional group. In the latter, the treatment was modified in 13 patients (36%). The hospital readmission rate was 17%, which was similar in both groups (P=.50). For every 5-year increase in age, the risk for readmission was 2.54 (95%CI, 1.06-5.07) and for each increase of 10mmHg in PaCO(2), the risk of readmission was 8.34 (95%CI, 2.43-18.55). CONCLUSIONS: Early home monitoring did not decrease the readmission rate during the first month. Older age and high PaCO(2) are factors that identify the group with a high risk for rehospitalization.
Authors: Alejandra Aranburu-Imatz; Juan de la Cruz López-Carrasco; Ana Moreno-Luque; José Manuel Jiménez-Pastor; María Del Rocío Valverde-León; Francisco José Rodríguez-Cortés; Pedro Arévalo-Buitrago; Pablo Jesús López-Soto; Ignacio Morales-Cané Journal: Int J Environ Res Public Health Date: 2022-07-26 Impact factor: 4.614
Authors: María José Bujalance-Zafra; Miguel Domínguez-Santaella; Antonio Baca-Osorio; Leovigildo Ginel-Mendoza; Francisco Jesús Fernández-Vargas; Rafael Poyato-Ramos Journal: Aten Primaria Date: 2016-09-28 Impact factor: 1.137