Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a common and preventable condition. The disease accounts for a large economic burden in the US health care system. Better control and prevention of COPD exacerbations can help prevent presentations to already-crowded emergency departments (EDs) and hospitals. The objective of our study was to identify variables associated with hospital admission status in ED patients presenting with COPD exacerbation.Methods: We conducted a retrospective observational study of patients seen at 1 of 3 US EDs from 2012 to 2014 with a primary diagnosis related to COPD exacerbation. Hospital admission status was modeled using patient characteristic data via adaptive least absolute shrinkage and selection operator logistic regression. Study results are presented as adjusted odds ratios with 95% CIs. Planned post hoc model dependency and external data sensitivity analyses were conducted.Results: The study sample included 1,165 unique patients with COPD with an ED encounter related to exacerbation at 1 of the 3 reviewed hospitals. Approximately half of these patients had a hospital admission. Variables inversely associated with an admission included oxygen saturation and number of prior ED encounters for COPD exacerbation. Variables positively associated with admission were initial ED heart rate, patient age, and documented comorbidities of anxiety and/or depression. These mental health comorbidities had the strongest association with admission status.Conclusion: Understanding the characteristics of admitted patients may help direct resources and outpatient services to prevent encounters. Of note, the study revealed mental health variables as being strongly associated with admission status.
Highlights
Chronic obstructive pulmonary disease (COPD) is a common and preventable condition
Candidate quantitative variables were age, number of prior emergency departments (EDs) encounters for COPD exacerbation in the health system during the study period, and initial ED vital data
Receiver operator characteristic curve for the set of nonzero coefficients selected via adaptive least absolute shrinkage and selection operator model for variables associated with hospital admission status in patients seen in the emergency department (ED) for chronic obstructive pulmonary disease (COPD) exacerbation (n=1,165)
Summary
COPD is associated with a large economic burden in the US health care system. The objective of our study was to identify variables associated with hospital admission status in ED patients presenting with COPD exacerbation. Results: The study sample included 1,165 unique patients with COPD with an ED encounter related to exacerbation at 1 of the 3 reviewed hospitals. Half of these patients had a hospital admission. Variables positively associated with admission were initial ED heart rate, patient age, and documented comorbidities of anxiety and/or depression These mental health comorbidities had the strongest association with admission status. The study revealed mental health variables as being strongly associated with admission status
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
