SESSION TITLE: Outcomes in COPD
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 27, 2015 at 02:45 PM - 04:15 PM
PURPOSE: Length of hospitalization is a valuable measure for prediction of clinical outcome following admission in COPD patients. Prolonged length of stay in hospital has serious implications on the treatment cost and adverse events. We have tried to identify the factors associated with prolonged length of stay amongst patients admitted with COPD exacerbation.
METHODS: A retrospective cross sectional analysis conducted between July-December, 2013. Demographic and clinical data was extracted from medical records of 450 patients admitted with the diagnosis of COPD exacerbation. Logistic regression analysis was used to identify the predictors of prolonged length of stay.
RESULTS: Mean length of stay was 6 ±3.5 days. Approximately 46% (209) of the patients were ≥76 years with a median length of stay 5 days [IQR: 3-9 days]. In univariate logistic regression analysis age ≥76 years, male gender, BMI ≥30, functional status at admission and having co morbid conditions were significantly associated with a length of stay in hospital more than 5 days. Although in multivariate logistic regression analysis male gender [OR 1.42; 95% CI: 1.062-2.111], age >55 years [OR 2.070; 95% CI: 1.052-2.742], and BMI ≥30 [OR 1.698; 95% CI1.052-2.742], were found to be associated with prolonged hospitalization
CONCLUSIONS: In our study old age, male gender and obesity were found to be associated with prolonged LOS. Early identification of these factors can reduce LOS and consumption of health care resources. These findings may help physicians to identify patients who will need a prolonged hospitalization in the early stages of admission
CLINICAL IMPLICATIONS: In the United States the direct cost involved in the management of acute exacerbation of COPD is estimated to be around $29.5 billion and indirect cost of around $20.4 billion. According to our study obesity is one of the preventable risk factors, which is contributing to longer length of hospitalization. We strongly believe that addressing this risk factor more seriously in the hospital and outpatient setting, would have a significant impact on the cost involved in the management of a patient with COPD.
DISCLOSURE: The following authors have nothing to disclose: Maliha Naseer, Karthikeyan Venkatachalam, Rudin Gjeka, Sarwan Kumar, Bushra Waseem
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