Waarom belanden COPD patienten op de spoedeisende hulp?

INTRODUCTION

Reports on health care utilization of patients with chronic obstructive pulmonary disease (COPD) have shown high rates of hospital admissions for COPD-related medical emergencies, mostly acute exacerbations (1, 2). It is now well-established that COPD is a multi-component disease with high comorbidity rates of, for example, cardiovascular diseases, diabetes mellitus, and cancer (3). No data are available on non-respiratory reasons that force patients with COPD to present at the emergency room (ER). Such data will provide more insight into the burden of these patients and will be valuable to respiratory physicians, ER staff, as well as other specialists treating non-respiratory emergencies in patients with COPD.



METHODS

This retrospective study will be performed at Orbis Medical Center, a 425-bed rural teaching hospital in Sittard-Geleen, The Netherlands. All patients with COPD who visited the ER for any referral indication between 1 January 2012 and 31 December 2012 will be included. Patients with COPD will be identified by electronically screening patients' medical history documents. Subsequently, medical charts will be individually reviewed by a medical doctor (BvdB and KB) and the following data will be extracted: age, gender, height, weight, pulmonary function, Charlson co-morbidity index, referral indication, referral specialism, time and day of the week of the ER visit, decision at the ER (discharge or admission), admission duration, diagnoses at discharge from ER or hospital, vital status at time of data collection, and the last date of contact in those who are still alive.

Respiratory visits are defined as ER visits with respiratory symptoms (dyspnea, cough, haemoptysis, suspected pneumonia) as the primary reasons for the ER visit. All other ER visits are defined as non-respiratory ER visits.

Descriptive statistics will be used to provide summary characteristics of respiratory and non-respiratory ER visits. Survival difference will be analyzed by Kaplan-Meier curve analysis and predictors for mortality will be analyzed by Cox regression analyses. Date of last contact will be used for censoring.



REFERENCES

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It is expected that approximately 50% of the emergency room visits of COPD patients are not directly related to COPD.

Not applicable.

None