title: Clinical audit of patients hospitalized due to COPD exacerbation. MAG-1 Study.
abstract: Hospitalizations for acute exacerbation of COPD (AECOPD) generate high consumption of health resources, frequent readmissions and high mortality. The MAG -1 study aims to identify critical points to improve the care process of severe AECOPD requiring hospitalization.
  
  
  METHODS
  Observational study, with review of clinical records of patients admitted to hospitals of the Catalan public network for AECOPD. The centers were classified into 3 groups according to the number of discharges/year. Demographic and descriptive data of the previous year, pharmacological treatment, care during hospitalization and discharge process and follow-up, mortality and readmission at 30 and 90 days were analyzed.
  
  
  RESULTS
  A total of 910 patients (83% male) with a mean age of 74.3 (+10.1) years and a response rate of 70% were included. Smoking habit was determined in only 45% of cases, of which 9% were active smokers. In 31% of cases, no previous lung function data were available. Median hospital stay was 7 days (IQR 4-10), increasing according the complexity of the hospital. Mortality from admission to 90 days was 12.4% with a readmission rate of 49%. An inverse relationship between length of hospital stay and readmission within 90 days was observed.
  
  
  CONCLUSIONS
  In a large number of medical records, smoking habit and lung function tests were not appropriately reported. Average hospital stay increases with the complexity of the hospital, but longer stays appear to be associated with lower mortality at follow-up.
authors.affiliation: Programa de Atención a los Pacientes con Enfermedades Crónicas «Barcelona Esquerra», Hospital Clínic, Barcelona, España; Plan Director de las Enfermedades del Aparato Respiratorio (PDMAR), del Departamento de Salud, Generalitat de Catalunya, Barcelona y Observatorio de las Terapias Respiratorias, FORES; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC). Electronic address: ESCARRABILL@clinic.ub.es.
authors.forename: Joan
authors.initials: J
authors.lastname: Escarrabill
authors.affiliation: Plan Director de las Enfermedades del Aparato Respiratorio (PDMAR), del Departamento de Salud, Generalitat de Catalunya, Barcelona y Observatorio de las Terapias Respiratorias, FORES; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC); Departamento de Salud, Generalitat de Catalunya, Barcelona, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Torrente
authors.affiliation: Servicio de Neumología, Hospital Arnau de Vilanova y Hospital de Santa Maria, Lérida, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Esquinas
authors.affiliation: Plan Director de las Enfermedades del Aparato Respiratorio (PDMAR), del Departamento de Salud, Generalitat de Catalunya, Barcelona y Observatorio de las Terapias Respiratorias, FORES; Unidad de Atención Integrada Dirección Médica y de Enfermería, Hospital Clínic, Barcelona, España.
authors.forename: Carme
authors.initials: C
authors.lastname: Hernández
authors.affiliation: Servicio de Neumología, Hospital Universitari del Parc Taulí, Sabadell Barcelona, España.
authors.forename: Eduard
authors.initials: E
authors.lastname: Monsó
authors.affiliation: EAP Dreta de l'Eixample, Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Freixas
authors.affiliation: Servicio de Medicina Interna, Hospital Universitari Mútua de Terrassa, Terrassa Barcelona, España.
authors.forename: Pere
authors.initials: P
authors.lastname: Almagro
authors.affiliation: Plan Director de las Enfermedades del Aparato Respiratorio (PDMAR), del Departamento de Salud, Generalitat de Catalunya, Barcelona y Observatorio de las Terapias Respiratorias, FORES; Departamento de Salud, Generalitat de Catalunya, Barcelona, España.
authors.forename: Ricard
authors.initials: R
authors.lastname: Tresserras
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006748:Hospital Departments / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006753:Hospital Records; D006760:Hospitalization; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D010100:Oxygen
keywords: Audit; Auditoría; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Hospitalización; Hospitalization; Mortalidad; Mortality; Readmissions; Reingresos