Zaidi Farhan, Lee Ryan S, Buchcic Bartosz A, Bracken Nina E, Jaffe H Ari, Joo Min, Prieto-Centurion Valentin, Tan Ai-Yui, Krishnan Jerry A
Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago.
Jesse Brown Veterans Administration Medical Center, Chicago, Illinois.
Chronic Obstr Pulm Dis. 2017 Sep 20;4(4):287-296. doi: 10.15326/jcopdf.4.4.2017.0148.
Patients hospitalized with chronic obstructive pulmonary disease (COPD) who require supplemental oxygen (O) are at increased risk of hospital readmissions. There is a paucity of information regarding quality of evaluation and documentation regarding the need for supplemental O in this population. To determine the extent to which evaluation and documentation regarding the need for supplemental O occurs prior to hospital discharge in patients with COPD. We conducted a two-center retrospective cohort study of hospitalized adults with a physician diagnosis of COPD. We reviewed electronic health records to ascertain whether patients underwent evaluation beyond rest oximetry documenting hypoxemia and if there was adequate documentation of supplemental O requirements prior to discharge. Of 526 patients hospitalized with a primary or secondary discharge diagnosis of COPD, 335 patients (mean age 69 years, 78% with diagnosis of COPD exacerbation) met eligibility criteria. Overall, 1 in 5 (22%, 73/335) hospitalized patients with COPD had an evaluation beyond rest oximetry for supplemental O requirements during admission. Adequate documentation of supplemental O requirements occurred in even fewer patients (16%, 54/335). Both evaluation (26% versus 5%, =0.002) and documentation (19% versus 4%, =0.001) of supplemental O requirements were more common in patients hospitalized for a COPD exacerbation compared to those hospitalized with COPD but without an exacerbation. Evaluation and documentation of supplemental O requirements beyond rest oximetry occur infrequently in patients hospitalized with COPD.
因慢性阻塞性肺疾病（COPD）住院且需要补充氧气（O）的患者再次入院风险增加。关于该人群补充氧气需求的评估质量和记录信息匮乏。为了确定COPD患者出院前补充氧气需求的评估和记录情况。我们对两家中心诊断为COPD的住院成年患者进行了一项回顾性队列研究。我们查阅电子健康记录，以确定患者是否接受了除静息血氧测定以外的评估以记录低氧血症，以及出院前补充氧气需求是否有充分记录。在526例以COPD为主要或次要出院诊断住院的患者中，335例患者（平均年龄69岁，78%诊断为COPD加重）符合纳入标准。总体而言，五分之一（22%，73/335）的住院COPD患者在入院期间接受了除静息血氧测定以外的补充氧气需求评估。补充氧气需求有充分记录的患者更少（16%，54/335）。与因COPD住院但无加重的患者相比，因COPD加重住院的患者补充氧气需求的评估（26%对5%，P=0.002）和记录（19%对4%，P=0.001）更为常见。COPD住院患者中，除静息血氧测定以外的补充氧气需求评估和记录很少见。
