title: Factors associated with short-term recovery of health status among emergency department patients with acute exacerbations of chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To determine the factors associated with short-term recovery of health status following chronic obstructive pulmonary disease (COPD) exacerbation.
  
  
  METHODS
  In a prospective multicenter cohort study, consecutive emergency department (ED) patients with COPD exacerbation were enrolled. Patients were interviewed and instructed to complete the validated Short Form Chronic Respiratory disease Questionnaire. Follow-up data were collected 2 weeks later, and included the global transition question. The primary outcome was recovery of health status, which was assigned to patients who stated that their COPD was "a little better" or "much better" than at the time of their ED presentation.
  
  
  RESULTS
  Of the 330 patients, 270 [82%; 95% confidence interval (CI), 77-86%] reported recovery of health status following acute exacerbations. Multivariable analysis showed that recovery of health status was associated with having a primary care provider (PCP) [odds ratio (OR), 3.1; 95% CI, 1.5-6.4] and a co-diagnosis of asthma (OR, 2.2; 95% CI, 1.2-3.8). By contrast, frequent exacerbations (two or more exacerbations in the past year) (OR, 0.4; 95% CI, 0.2-0.7) was inversely associated with recovery.
  
  
  CONCLUSIONS
  Reducing exacerbation frequency and provision of adequate PCP follow-up after ED visit may help improve the recovery of health status following acute exacerbations of COPD.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 326 Cambridge St., Suite 410, Boston, MA, 02114, USA. cltsai@post.harvard.edu
authors.forename: Chu-Lin
authors.initials: CL
authors.lastname: Tsai
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000628:therapy*