Effect of PaO2 and social circumstances on outcomes in out-patient treatment of COPD exacerbations.
The current British Thoracic Society guidelines on COPD recommend that patients with COPD exacerbations should be admitted to hospital if they either have partial pressure of arterial oxygen of <7.0 kilopascals (kPa) or if they are living alone. This study was carried out to see if either of these factors have any effect on the outcome in patients presenting with COPD exacerbation in the setting of well established COPD services. This study was to see if patients with PaO2 < 7.0 kPa or those living alone were readmitted more frequently or had higher mortality than other patients discharged through the same scheme. A retrospective analysis was carried out on 1078 patients with acute exacerbation of COPD who were discharged home through Wigan "hospital at home" scheme in the period between November 1999 and February 2004 prior to the introduction of the new guidelines. This study found that there was no statistically significant difference in the rates of readmissions in patients with low PaO2 or those living in adverse social circumstances compared to other groups of patients. The number of patients dying in this period was too small to analyse with adequate power. This study indicates that such patients can be safely managed at home in the context of well established COPD services.
Khalid
S
S
COPD Unit, Royal Albert Edward Infirmary, Wigan, Lancashire, UK. skhalid@doctors.org.uk
Elliott
A C
AC
Pilling
A
A
Wolstenholme
R J
RJ
D000328:Adult; D017028:Caregivers; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008297:Male; D017063:Outcome Assessment, Health Care; D010100:Oxygen / Q000097:blood*; D010359:Patient Readmission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications / Q000628:therapy*; D012944:Social Support; D016896:Treatment Outcome; D006113:United Kingdom
D010100:Oxygen