Source: Annual Congress 2002 - Chronic care and rehabilitation in the management of acute exacerbations
Disease area: Airway diseases

Abstract

Acute exacerbations of chronic obstructive pulmonary disease(COPD) are an important cause of hospital admission. The aim of our study was to investigate the effect of an early supported discharge programme on hospital length of stay, lung function, dyspnoea and quality of life in patients with mild/moderate COPD.Fifty Patients, 19 male and 31 female, mean age 70 years (±] 8.9years)were discharged home with the support of respiratory physiotherapist and nurse over a four month period. 18 %(9) patients lived alone, mean smoking pack years 63 (±]42), 50%(25) were current smokers.The COPD Outreach discharge care package included a course of antibiotics and steroids, bronchodilators,visits by the outreach team to monitor patient progress, to provide education and early exercise until discharge. Assessment at discharge, day 14,6weeks and 3 months consisted of spirometry, SpO2 measurement, Dyspnoea scales (Borg, medical research council dyspnoea scale) and quality of life scores (EuroQol). The average length of stay was 2.5 days (±]2). The average hospital length of stay for an exacerbation of COPD is 10.19 days (HIPE 2000). 7 patients (14%) were readmitted within 14 days with one patient death. There was a significant improvementp<.005 in FEV1,FVC,Sp02,Borg,MRC and EuroQol between day of discharge and day 14 and these were sustained up to 3 months.

	Discharge	Day 14	6 weeks	3 Months
Fev1%pred.	40%±]17	45%±]18	47%±]18	61%±]17
MRC	3±]1	1.5±]1	1±].7	0.5±]1

We conclude that patients admitted with an acute exacerbation of COPD may be safely and successfully discharged home early with the support of a hospital based Outreach team.

Rating:

Share or cite this content

Citations should be made in the following way:
N. M. Murphy, C. C. Byrne, F. M. Keoghan, R. W. Costello (Dublin, Ireland). The efficacy of an early supported discharge programme for patients admitted to hospital with an exacerbation of COPD. Eur Respir J 2002; 20: Suppl. 38, 3711

Member's Comments

No comment yet.

Related content which might interest you: Early admission predictors in COPD patients admitted at hospital for an exacerbation Source: Annual Congress 2010 - COPD exacerbation Year: 2010 The impact on hospital admissions of a nurse-led rapid response respiratory discharge service for patients admitted with acute exacerbation of COPD in a district general hospital Source: Eur Respir J 2006; 28: Suppl. 50, 133s Year: 2006 What are the needs of patients after discharge from hospital with an acute exacerbation of COPD? Source: Eur Respir J 2007; 30: Suppl. 51, 127s Year: 2007 Influence of previous admissions on audit outcomes in patients admitted with acute exacerbation of COPD (AECOPD) Source: International Congress 2017 – What is new in COPD diagnosis and classification? Year: 2017 Early rehabilitation in COPD patients admitted for acute exacerbation Source: ISSN=ISSN 1810-6838, ISBN=, page=245 Year: 2005 Characteristics and outcome of patients admitted to intensive care with acute exacerbation of COPD Source: Eur Respir J 2006; 28: Suppl. 50, 393s Year: 2006 A retrospective study of antibiotic prescribing for patients admitted to hospital with exacerbation of COPD Source: Annual Congress 2007 - Different aspects of COPD exacerbations Year: 2007 Under nutrition is common in patients admitted to hospital with exacerbations of COPD Source: International Congress 2019 – Comorbidities in COPD and asthma: body composition and diabetes Year: 2019 The effects of real-time telemedicine consultations between hospital-based nurses and severe COPD patients discharged after exacerbation admissions Source: Annual Congress 2013 –Respiratory nursing care: assessment, interventions and education Year: 2013 Characteristics of patients admitted to a respiratory hospital due to COPD exacerbation Source: Eur Respir J 2005; 26: Suppl. 49, 285s Year: 2005 Outcomes of COPD patients admitted to an intensive care unity during acute exacerbations and one year follow-up Source: Annual Congress 2010 - Intensive care unit outcome Year: 2010 Effects of an early rehabilitation program in COPD exacerbation, after an hospital discharge, one-year follow-up Source: International Congress 2018 – Integrated care and non-pharmacological management of COPD Year: 2018 An audit of salbutamol use before children are admitted to hospital with acute asthma Source: Virtual Congress 2020 – Diagnosis and management of airways disease in primary care Year: 2020 Clinical differences between patients admitted to hospital with an acute or non-acute exacerbation of COPD Source: Annual Congress 2007 - Different aspects of COPD exacerbations Year: 2007 Predicting hospital readmission in patients discharged following acute exacerbations of COPD (AECOPD) Source: Annual Congress 2012 - COPD exacerbation Year: 2012 Evaluation of pulmonary rehabilitation to reduce hospital admissions in COPD patients Source: Annual Congress 2010 - Exacerbations and COPD and rehabilitation Year: 2010 Referral to pulmonary rehabilitation amongst patients admitted to hospital with COPD Source: Annual Congress 2012 - The latest insights in pulmonary rehabilitation Year: 2012 Impact of an in-patient pulmonary rehabilitation programme on functional capacity and length of hospital stay in hospitalised COPD patients Source: Annual Congress 2009 - New treatment and outcome measures for pulmonary rehabilitation Year: 2009 Hospital at home for COPD exacerbations:A&E vs early hospital discharge Source: Eur Respir J 2002; 20: Suppl. 38, 203s Year: 2002 Efficiency of a home follow-up program after a COPD exacerbation as a way to reduce hospital readmissions Source: Virtual Congress 2020 – New and integrated tools for respiratory diagnosis and care Year: 2020