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Chronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals – EvaluateCOPDpt, a multicentre, observational, prospective study

2024-11Journal article Open access
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dc.contributor.authorMoita, J.
dc.contributor.authorBrito, U.
dc.contributor.authorRodrigues, C.
dc.contributor.authorFerreira, L.
dc.contributor.authorVieira, J. R.
dc.contributor.authorCatarino, A.
dc.contributor.authorMorais, A.
dc.contributor.authorHespanhol, V.
dc.contributor.authorCordeiro, C. R.
dc.date.accessioned2024-12-19T12:53:28Z
dc.date.available2024-12-19T12:53:28Z
dc.date.issued2024-11
dc.description.abstractIntroduction and Objectives: In order to improve the quality of chronic obstructive pulmonary disease (COPD) patients' care, better knowledge of clinical practice and the factors associated with patient outcomes are needed. This study aimed to evaluate the relation between clinical practice and the outcomes of patients admitted for COPD exacerbations in Portuguese hospitals. Materials and Methods: Observational, multicentre, prospective study with a 60-days follow-up period, in 11 hospitals, including patients aged > 30 years, admitted to hospital for at least 24 hours due to an acute exacerbation of COPD. Demographic and clinical data were collected, symptoms, and treatment. Sixty days after discharge, COPD exacerbations management, outcome measures, and readmission data were evaluated through a structured phone follow-up interview. Results: 196 patients were included (85.7% male, mean age 71.2 years), the majority admitted through the emergency service. Ex-smokers and current smokers accounted for 51% and 36%, respectively. On admission, 72.4% were on LAMA, 54.6% on LABA, and 45.5% were on LABA/ LAMA. Inhaled corticosteroids (ICS) were used in 37.3% and systemic steroids (SCS) in 10.3%. 35.7 Pulmonology 30 (2024) 522-528 38.3% with non-invasive ventilation. Additionally, 93.4% used SCS and 60.2% ICS. Antibiotics were administered to 85.2%. 95.4% of patients were discharged; 9 died, 5 of whom had a COPD-related death. The median length of stay was 12 days for discharged patients and 33 days for patients who died. At discharge, 79.1% were prescribed with LAMA, 63.6% SCS, 61.5% LABA and 55.6% LAMA+LABA. 26,2% were prescribed with ICS+LABA+LAMA. At follow-up, 44.4% had a scheduled medical appointment within the 60 days after being discharged, and 28.3% were later readmitted due to exacerbation, of whom 52.8% were hospitalised. Conclusions: The severity of COPD, particularly in exacerbations, is directly related to impaired lung function and quality of life, mortality, and significant health system costs. Knowledge about COPD exacerbations' management in acute hospital admissions in Portugal may help stimulate a national discussion and review of existing data to engage clinicians, policymakers, managers, and patients, raising awareness and promoting action on COPD. (c) 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).eng
dc.identifier.doi10.1016/j.pulmoe.2022.07.007
dc.identifier.issn2531-0437
dc.identifier.urihttp://hdl.handle.net/10400.1/26515
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S2531043722001556?via%3Dihub
dc.relation.ispartofPulmonology
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCOPD
dc.subjectChronic obstructive pulmonary disease
dc.subjectDisease management
dc.subjectExacerbations
dc.titleChronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals – EvaluateCOPDpt, a multicentre, observational, prospective studyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage528
oaire.citation.issue6
oaire.citation.startPage522
oaire.citation.titlePulmonology
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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