How Long Should We Be Vigilant after a Hospitalization for a Chronic Obstructive Pulmonary Disease Exacerbation?

• Published in: American journal of respiratory and critical care medicine Vol. 197; no. 8; pp. 975 - 977
• Main Authors: Tan, Ai-Yui M, Krishnan, Jerry A
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 15.04.2018
• Subjects: Caregivers; Chronic obstructive pulmonary disease; Heart attacks; Heart failure; Hospitals; Medicare; Mortality; Ostomy; Patients; Pneumonia; Population; United States > US; Europe
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.201712-2612ED

Multiple factors contribute to the variability in the 30-day risks for readmissions and death, including the need for ventilatory support for respiratory failure, use of home oxygen, presence of coexisting conditions, patient's social support and other socioeconomic factors, patient self-management skills and behaviors, quality of inpatient care, and accessibility to high-quality postdischarge care (3-7). In response to these observations in the United States and similar findings in other countries, policymakers have sought to reduce the short-term risk for adverse outcomes by promoting the delivery of transitional care services tailored to the populations that hospitals serve (8, 9). [...]the peak daily risks of readmissions (about 1% per day) and death (just under 0.5% per day) among U.S. Medicare beneficiaries after a hospitalization for a COPD exacerbation occur within the first few days of hospital discharge. [...]about 5% of all hospitalizations for COPD exacerbations included invasive ventilation (using an artificial airway, such as an endotracheal tube or tracheostomy), and about 6% included noninvasive ventilation.