Lau A C, Yam L Y, Poon E
Respiratory and Critical Care Team, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, PR China.
Respir Med. 2001 Nov;95(11):876-84. doi: 10.1053/rmed.2001.1180.
A retrospective study was carried out in a Hong Kong regional hospital with 24-h emergency service, to study the factors associated with shorter time to re-admission after acute exacerbation of chronic obstructive pulmonary disease (COPD). From 1 January 1997 to 31 December 1997, the first admission (index admission) of each patient through the emergency room with COPD/chronic bronchitis/emphysema was included. A total of 551 patients fulfilled the inclusion criteria. The total acute and rehabilitative length of stay (mean +/- SD) was 9.41+/-11.67 days. Within 1 year after discharge, 327 patients (59 35%) were re-admitted at least once. Median time to first re-admission after discharge was 240 days. By Cox regression analysis, the following factors were independently associated with shorter time to re-admission: hospital admission within 1 year before index admission, total length of stay in index admission > 5 days, nursing home residency, dependency in self-care activities, right heart strain pattern on electrocardiogram, on high dose inhaled corticosteroid and actual bicarbonate level > 25 mmol l(-1). These factors may be relevant in the future planning of healthcare utilization for COPD patients.
在一家提供24小时急诊服务的香港地区医院进行了一项回顾性研究，以探讨与慢性阻塞性肺疾病（COPD）急性加重后再入院时间较短相关的因素。从1997年1月1日至1997年12月31日，纳入了每位通过急诊室首次入院（索引入院）诊断为COPD/慢性支气管炎/肺气肿的患者。共有551例患者符合纳入标准。急性和康复住院总时长（均值±标准差）为9.41±11.67天。出院后1年内，327例患者（59.35%）至少再次入院1次。出院至首次再入院的中位时间为240天。通过Cox回归分析，以下因素与再入院时间较短独立相关：索引入院前1年内曾住院、索引住院总时长>5天、居住在养老院、日常生活活动依赖、心电图显示右心劳损模式、使用高剂量吸入性糖皮质激素以及实际碳酸氢盐水平>25 mmol/L。这些因素可能与未来COPD患者医疗利用规划相关。
