title: Factors affecting revisit of COPD exacerbated patients presenting to emergency department.
abstract: The primary purpose of this prospective cohort study was to characterize the use of the Emergency Department (ED) in patients with chronic obstructive pulmonary disease (COPD) exacerbations and determine the factors affecting the revisit of COPD patients. This is a prospective cohort study on ambulatory patients with exacerbated chronic bronchitis in an ED setting. Patients included in the study were above 18 years of age, had a previous diagnosis of COPD, and presented to the ED for the treatment of COPD exacerbation. All the information relevant to the study was collected during the patient's visit to the ED. Revisit was defined as an unscheduled visit to an ED or primary physician within 2 weeks of initial ED visit for worsening COPD symptoms. Telephone follow-up was done on all patients at the end of 2 weeks. Variables of 26 revisit cases versus 78 nonrevisit cases were compared. Home oxygen therapy, intensive care admission, previous intubation, increased cough, and the number of ED visits in the previous year were associated with increased risk of revisit in the univariate analysis. Increased cough (odds ratio: 0.232; 95% confidence interval: 0.063-0.853) and the number of ED visits in the previous year (odds ratio: 1.166; 95% confidence interval: 1.005-1.353) were still significant after multivariate analysis. In conclusion, the number of ED visits previous year and increased cough can predict the revisit of a COPD exacerbated patient within 14 days of an ED visit.
authors.affiliation: Department of Emergency Medicine, Akdeniz University School of Medicine Antalya, Turkey. erkangoksu@akdeniz.edu.tr
authors.forename: Erkan
authors.initials: E
authors.lastname: Goksu
authors.forename: Cem
authors.initials: C
authors.lastname: Oktay
authors.forename: Mutlu
authors.initials: M
authors.lastname: Kartal
authors.forename: Alten
authors.initials: A
authors.lastname: Oskay
authors.forename: Ali Vefa
authors.initials: AV
authors.lastname: Sayrac
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000473:pathology; D019233:Retreatment / Q000706:statistics & numerical data; D012307:Risk Factors; D013689:Telephone