Early predictors of hospital admission in emergency department patients with chronic obstructive pulmonary disease

Considine, Julie, Botti, Mari and Thomas, Shane 2011, Early predictors of hospital admission in emergency department patients with chronic obstructive pulmonary disease, Australasian emergency nursing journal, vol. 14, no. 3, pp. 180-188.

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Title Early predictors of hospital admission in emergency department patients with chronic obstructive pulmonary disease
Author(s) Considine, Julie
Botti, Mari
Thomas, Shane
Journal name Australasian emergency nursing journal
Volume number 14
Issue number 3
Start page 180
End page 188
Publisher Elsevier Ltd
Place of publication Oxford, U. K.
Publication date 2011-08
ISSN 1574-6267
Keyword(s) chronic obstructive pulmonary disease (COPD)
emergency medicine
hospitalisation
decision modeling
Summary Background: Streamlining emergency department (ED) care of patients with chronic obstructive pulmonary disease (COPD) may be an important strategy in managing the increasing burden of this disease.

Study objectives: The aim of this study was to identify factors predictive of hospital admission in ED patients with COPD, specifically factors that can be used early in the ED episode of care.

Methods: Using retrospective regression analysis, case data from 321 randomly selected medical records from five Australian EDs were analysed. Patient characteristics, triage and ED system features, physiological status, and ED treatment during the first four hours of ED care were compared between discharged and admitted patients.

Results: Factors available on ED arrival associated with increased likelihood of admission were: age (OR = 1.04, p = 0.008) respiratory symptoms affecting activities of daily living (OR = 1.8, p = 0.043) and signs of respiratory dysfunction (OR = 2.5, p = 0.005). Factors available from the first four hours of ED care associated with increased likelihood of admission were: age (OR = 1.04, p = 0.021), oxygen use at four hours (OR = 3.5, p = 0.002) and IV antibiotic administration (OR = 2.6, p = 0.026). There were conflicting findings regarding the association between ambulance transport and admission.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30041538

Document type: Journal Article
Collection: School of Nursing and Midwifery
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