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Early predictors of hospital admission in emergency department patients with chronic obstructive pulmonary disease
journal contribution
posted on 2011-08-01, 00:00 authored by Julie ConsidineJulie Considine, Mari BottiMari Botti, S ThomasBackground: 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.
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.
History
Journal
Australasian emergency nursing journalVolume
14Issue
3Pagination
180 - 188Publisher
Elsevier LtdLocation
Oxford, U. K.Publisher DOI
ISSN
1574-6267Language
engPublication classification
C1 Refereed article in a scholarly journal; C Journal articleCopyright notice
2011, College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.Usage metrics
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