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2012, Number 2

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Medisur 2012; 10 (2)

Applying an Instrument for Stratification of Patients with Decompensated Chronic Obstructive Pulmonary Disease in the Emergency Room

Corona MLA, Leyva RL, Sierra MDP
Full text How to cite this article

Language: Spanish
References: 12
Page: 9-19
PDF size: 166.39 Kb.


Key words:

Pulmonary disease, chronic obstructive, evaluation of research programs and tools, emergencies Limits, Humans, adult.

ABSTRACT

Background: Chronic obstructive pulmonary disease is a public health problem of enormous magnitude. This has also been considered at the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos.
Objective: To assess the implementation process of a tool for stratification of patients with chronic obstructive pulmonary disease treated in the Emergency Room.
Methods: The instrument was administered to 192 patients admitted and discharged from the institution with a diagnosis of decompensated chronic obstructive pulmonary disease from May 2010 to April 2011. Several indicators of process and outcome were used for the assessment.
Results: The use of the instrument became a medical action quickly and systematically incorporated, although not accompanied by progressive improvement in stratification quality. The prevalence of patients at high risk of adverse outcome and high probability of recovery was determined by a large number of patients with moderate decompensation and association with pneumonia or heart failure, which were mostly stratified as moderate risk and admitted in Internal Medicine rooms. Nevertheless, lethality was relatively low, as well as the frequency of transfers to intensive care units of patients initially admitted to these rooms (10%).
Conclusions: The results obtained in the behavior of lethality and the rate of transfers to intensive care units suggest the convenience of performing modifications to the stratification instrument used.


REFERENCES

  1. Celli BR, Macnee W, Agusti A, Anzueto A, Bert B, Buits AS, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. ERJ. 2004;23(6):932-46.

  2. Epidemiology of chronic obstructive pulmonary disease exacerbations. Clin Pulm Med. 2002;9:191-7.

  3. Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario estadístico de salud 2010. Ciudad de La Habana: MINSAP; 2011.

  4. Aaron SD, Vandemheen KL, Fergusson D, Maltais F, Bourbeau J, Goldstein R, et al. Tiotropium in combination with placebo, salmeterol, or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med. 2007;146(8):545-55.

  5. Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and Fluticasone Propionate and Survival in Chronic Obstructive Pulmonary Disease. N Engl J Med. 2007;356(8):775-89.

  6. Soler-Cataluña JJ, Martínez-García MA, Román SP, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005;60(11):925-31.

  7. Casas A, Troosters T, Garcia-Aymerich J, Roca J, Hernández C, Alonso A, et al. Integrated care prevents hospitalizations for exacerbations in COPD patients. ERJ. 2006;28(1):123-30.

  8. Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Anto JM. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study. Thorax. 2006;61(9):772-8.

  9. Nici L, Donner C, Wouters E, Ziwallack R, Ambrosino N, Bourbeau J, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173(12):1390-413.

  10. 10.Rivero González G. Estratificación pronóstica en los pacientes con EPOC agudizada que requieren hospitalización. Más humo que señales. Arch Bronconeumol. 2007;43(11):640.

  11. 11.Corona Martínez LA, Fragoso Marchante MC, González Morales I, Hernández Abreus C, Sierra Martínez D, Fresneda Quintana O. Valoración del índice de riesgo como instrumento para la estratificación del paciente con neumonía adquirida en la comunidad en el Departamento de Urgencias. Medisur[revista en Internet]. 2005[citada 20 May 2011];3(2):[aprox. 5 p.]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/108/4741.

  12. 12.Corona Martínez LA, Fragoso Marchante MC, Borroto Lecuna S, Hernández Abreus C, Homes López-Viera B, Domínguez Casillas I. Un instrumento para la estratificación del paciente con neumonía adquirida en la comunidad en el departamento de urgencias. Rev Cubana Med[revista en Internet]. 2006[citado 20 May 2011];45(2):[aprox. 11 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232006000200012.




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Medisur. 2012;10