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哮喘急性加重:再次入院的危险因素。

Asthma exacerbations: risk factors for hospital readmissions.

作者信息

Gonzalez-Barcala F-J, Calvo-Alvarez U, Garcia-Sanz M-T, Garcia-Couceiro N, Martin-Lancharro P, Pose A, Carreira J-M, Moure-Gonzalez J-D, Valdes-Cuadrado L, Muñoz X

机构信息

Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

Ir J Med Sci. 2018 Feb;187(1):155-161. doi: 10.1007/s11845-017-1633-9. Epub 2017 Jun 7.

Abstract

OBJECTIVE

The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase.

STUDY DESIGN

We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010.

METHODS

The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study. An early readmission (ER) was defined as that which occurred in the following 15 days after hospital discharge and late readmission (LR) to that occurring from 16 days after discharge.

RESULTS

This study included 2166 hospital admissions and 1316 patients, with a mean age of 62.6 years. Of the 1316 patients analysed, 36 (2.7%) had one ER and 313 (23.8%) one LR. The only factor independently associated with a higher probability of an ER was poor lung function. A higher probability of LR was associated with a greater severity of the asthma (OR: 17.8, for severe asthma versus intermittent asthma), to have had any hospital admission in the previous year (OR: 3.5) and the use of a combination of ICS-LABA as maintenance treatment.

CONCLUSIONS

About 25% of the patients in our area admitted to hospital due to asthma exacerbation had repeat episodes of hospitalisation.

摘要

目的

本研究旨在分析哮喘导致的医院再入院情况及其增加的相关因素。

研究设计

我们进行了一项回顾性研究,纳入了2000年至2010年间在我院因哮喘加重而入院的所有18岁以上患者。

方法

研究团队的两名成员通过查阅临床记录收集数据。本研究纳入了每位患者的首次住院情况。早期再入院(ER)定义为出院后15天内发生的再入院,晚期再入院(LR)定义为出院16天后发生的再入院。

结果

本研究包括2166次住院和1316名患者,平均年龄为62.6岁。在分析的1316名患者中,36人(2.7%)有一次早期再入院,313人(23.8%)有一次晚期再入院。与早期再入院概率较高独立相关的唯一因素是肺功能差。晚期再入院概率较高与哮喘病情更严重(重度哮喘与间歇性哮喘相比,比值比:17.8)、上一年有过任何住院史(比值比:3.5)以及使用吸入性糖皮质激素-长效β2受体激动剂联合制剂作为维持治疗有关。

结论

在我们地区,因哮喘加重入院的患者中约25%有再次住院的情况。

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