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dc.contributor.authorKelly, Anne-Maree
dc.contributor.authorVan Meer, Oene
dc.contributor.authorKeijzers, Gerben
dc.contributor.authorMotiejunaite, Justina
dc.contributor.authorJones, Peter
dc.contributor.authorBody, Richard
dc.contributor.authorCraig, Simon
dc.contributor.authorKaramercan, Mehmet
dc.contributor.authorKlim, Sharon
dc.contributor.authorHarjola, Veli-Pekka
dc.contributor.authorVerschuren, Franck
dc.contributor.authorHoldgate, Anna
dc.contributor.authorChrist, Michael
dc.contributor.authorGolea, Adela
dc.contributor.authorGraham, Colin A
dc.contributor.authorCapsec, Jean
dc.contributor.authorBarletta, Cinzia
dc.contributor.authorGarcia-Castrillo, Luis
dc.contributor.authorKuan, Win S
dc.contributor.authorLaribi, Said
dc.date.accessioned2019-10-11T02:33:38Z
dc.date.available2019-10-11T02:33:38Z
dc.date.issued2020
dc.identifier.issn1444-0903
dc.identifier.doi10.1111/imj.14323
dc.identifier.urihttp://hdl.handle.net/10072/388307
dc.description.abstractOBJECTIVES: Exacerbations of chronic obstructive pulmonary disease (COPD) are common in emergency departments (ED). Guidelines recommend administration of inhaled bronchodilators, systemic corticosteroids and antibiotics along with non-invasive ventilation (NIV) for patients with respiratory acidosis. We aimed to determine compliance with guideline recommendations for patients with treated for COPD in ED in Europe (EUR) and South East Asia/Australasia (SEA) and to compare management and outcomes. METHODS: In each region, an observational prospective cohort study was performed that included patients presenting to EDs with the main complaint of dyspnoea during three 72-hour periods. This planned sub-study included those with an ED primary discharge diagnosis of COPD. Data were collected on demographics, clinical features, treatment, disposition and in-hospital mortality. We determined overall compliance with guideline recommendations and compared treatments and outcome between regions. RESULTS: 801 patients were included from 122 EDs (66 EUR and 46 SEA). Inhaled bronchodilators were administered to 80.3% of patients, systemic corticosteroids to 59.5%, antibiotics to 44% and 60.6% of patients with pH <7.3 received NIV. The proportion administered systemic corticosteroids was higher in SEA (EUR vs. SEA for all comparisons; 52% vs. 66%, p<0.001) as was administration of antibiotics (40% vs. 49%, p=0.02). Rates of NIV and mechanical ventilation were similar. Overall in-hospital mortality was 4.2% (SEA 3.9% vs. EUR 4.5%, p=0.77). CONCLUSION: Compliance with guideline recommended treatments, in particular administration of corticosteroids and NIV, was sub-optimal in both regions. Improved compliance has the potential to improve patient outcome. This article is protected by copyright. All rights reserved.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley
dc.relation.ispartofjournalInternal Medicine Journal
dc.subject.fieldofresearchCardiorespiratory Medicine and Haematology
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode1102
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1117
dc.subject.keywordsCOPD
dc.subject.keywordsDyspnoea
dc.subject.keywordsemergency department
dc.subject.keywordsmanagement
dc.subject.keywordsoutcome
dc.titleGet With The Guidelines - Management Of COPD In EDs In Europe And Australasia is sub-optimal
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationKelly, A-M; Van Meer, O; Keijzers, G; Motiejunaite, J; Jones, P; Body, R; Craig, S; Karamercan, M; Klim, S; Harjola, V-P; Franck, V; Holdgate, A; Christ, M; Golea, A; Graham, CA; Capsec, J; Barletta, C; Garcia-Castrillo, L; Kuan, WS; Laribi, S; AANZDEM and EuroDEM study groups, Get With The Guidelines - Management Of COPD In EDs In Europe And Australasia is sub-optimal., Internal Medicine Journal, 2019
dcterms.dateAccepted2019-04-08
dc.date.updated2019-10-11T02:27:10Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.rights.copyright© 2019 Royal Australasian College of Physicians. This is the peer reviewed version of the following article: Get With The Guidelines ‐ Management Of COPD In EDs In Europe And Australasia is sub‐optimal, Internal Medicine Journal, which has been published in final form at 10.1111/imj.14323. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
gro.hasfulltextFull Text
gro.griffith.authorKeijzers, Gerben


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