Treatment strategies after acute exacerbations of chronic obstructive pulmonary disease: Impact on mortality

dc.contributor.authorCasas-Méndez, Luis Fernando
dc.contributor.authorAbadías, María José
dc.contributor.authorYuguero Torres, Oriol
dc.contributor.authorBardés Robles, Ignasi
dc.contributor.authorBarbé Illa, Ferran
dc.contributor.authorBatlle Garcia, Jordi de
dc.date.accessioned2019-01-23T10:14:59Z
dc.date.available2019-01-23T10:14:59Z
dc.date.issued2018
dc.description.abstractIntroduction Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common reason for presentation to emergency departments (ED), but the management of these episodes is often heterogeneous regardless of their potential impact on short-term adverse outcomes. Methods This was a longitudinal, retrospective study of all patients>40 years old admitted to the ED of two Spanish teaching hospitals for an AECOPD between January 1st and May 31st, 2016. All data were collected from electronic medical records. The primary outcomes were patient treatment at discharge and 90-day mortality. Logistic regression was used to model the determinants of 90-day mortality. Results Of the 465 included patients, 56% were prescribed a 3-drug combination at hospital discharge, 22% a 2-drug combination, 19% a single drug, and 4% other or no treatment. Approximately 8% of patients died within 90 days after an AECOPD. Multivariate logistic models revealed that having more than 2 severe exacerbations within the last 12 months (OR (95% CI): 15.12 (4.22–54.22)) and being prescribed a single drug at discharge (OR (95% CI): 7.23 (2.44– 21.38)) were the main determinants of 90-day mortality after an AECOPD. Conclusions This study reflects the real-life heterogeneity in the pharmacological treatments prescribed after an ED admission for an AECOPD and suggests the potential impact of suboptimal inhaled treatment strategies on 90-day mortality rates.ca_ES
dc.description.sponsorshipThis research was supported by ALLER, Menarini Spain and GSK Spain. Jordi de Batlle acknowledges a research contract from Departament de Salut [PERIS 2016: SLT002/16/ 00364].ca_ES
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0208847
dc.identifier.idgrec027981
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/10459.1/65610
dc.language.isoengca_ES
dc.publisherPublic Library of Scienceca_ES
dc.relation.isformatofReproducció del document publicat a https://doi.org/10.1371/journal.pone.0208847ca_ES
dc.relation.ispartofPLoS ONE, vol. 13, núm. 12, e0208847ca_ES
dc.rightscc-by (c) Fernando Casas et al., 2018ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleTreatment strategies after acute exacerbations of chronic obstructive pulmonary disease: Impact on mortalityca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/publishedVersionca_ES
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