Murphy N M, Byrne C C, O'Neill S J, McElvaney N G, Costello R W
Department of Medicine, Beaumont Hospital, Beaumont Dublin 9, Ireland.
Ir Med J. 2003 May;96(5):137-40.
Chronic obstructive pulmonary disease is a common clinical condition characterised by airflow obstruction. The clinical course of the disease is characterised by intermittent exacerbations. In Ireland exacerbations of chronic obstructive pulmonary disease are a common cause of admission to acute medical hospitals. The Beaumont Hospital COPD Outreach Programme was designed to provide care at home for patients with an exacerbation of COPD that would otherwise require hospitalisation. Patients recruited to the programme were discharged home within 72 hours of admission and reviewed by the Outreach Team over a two week period. In addition to monitoring clinical progress the Team provided education, smoking cessation and medication advice. Analysis of the outcome of the first 100 patients recruited to the study show that one third of patients admitted to Hospital with an exacerbation of COPD are eligible for this programme and the average length of Hospital stay was 2.6 days. During the fourteen day follow up there was one death (non-respiratory) and six patients were re-admitted to hospital. Forty percent of smokers had abstained from smoking at the end of three months. In summary, the COPD Outreach programme is a safe and effective alternative to acute hospital care for selected patients with exacerbations of COPD.
慢性阻塞性肺疾病是一种以气流受限为特征的常见临床病症。该疾病的临床病程以间歇性恶化为特点。在爱尔兰，慢性阻塞性肺疾病的恶化是急性内科医院收治患者的常见原因。博蒙特医院慢性阻塞性肺疾病外展项目旨在为那些慢性阻塞性肺疾病恶化、否则需要住院治疗的患者提供居家护理。入选该项目的患者在入院72小时内出院，并由外展团队在两周内进行复查。除了监测临床进展外，该团队还提供教育、戒烟和用药建议。对入选该研究的前100名患者的结果分析表明，三分之一因慢性阻塞性肺疾病恶化而入院的患者符合该项目条件，平均住院时间为2.6天。在14天的随访期间，有一例死亡（非呼吸相关），6名患者再次入院。40%的吸烟者在三个月末戒烟。总之，对于选定的慢性阻塞性肺疾病恶化患者，慢性阻塞性肺疾病外展项目是急性医院护理的一种安全有效的替代方案。
