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dc.contributor.authorKhialani, Bharat
dc.contributor.authorSivakumaran, Pathmanathan
dc.contributor.authorKeijzers, Gerben
dc.contributor.authorSriram, Krishna Bajee
dc.date.accessioned2017-05-03T14:21:46Z
dc.date.available2017-05-03T14:21:46Z
dc.date.issued2014
dc.identifier.issn1735-1995
dc.identifier.urihttp://hdl.handle.net/10072/67402
dc.description.abstractBackground: Currently there is a paucity of information about biomarkers that can predict hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients presenting to the emergency department (ED). There is limited data on the consistency of ED management of AECOPD with local COPD guidelines. The aim of this study was to identify biomarkers associated with hospitalization in AECOPD patients and to determine if the ED management was concordant with local COPD guidelines. Materials and Methods: We performed a retrospective audit of consecutive AECOPD patients presenting to the Gold Coast Hospital ED over a 6-month period. Results: During the study period, 122 AECOPD patients (51% male, mean age (SE) 71 (ᱱ) years) presented to the ED. Ninety-eight (80%) patients were hospitalized. Univariate analysis identified certain factors associated with hospitalization: Older age, former smokers, home oxygen therapy, weekday presentation, SpO < 92%, and raised inflammatory markers (white cell count (WCC) and C-reactive protein (CRP)). After adjustment for multiple variable, increased age was significantly associated with hospitalization (odds ratio (OR) 1.09; 95% confidence interval (CI): 1.00-1.18; P = 0.05). Radiology assessment and pharmacological management was in accordance with COPD guidelines. However, spirometry was performed in 17% of patients and 28% of patients with hypercapneic respiratory failure received noninvasive ventilation (NIV). Conclusion: We identified several factors on univariate analysis that were associated with hospitalization. Further research is required to determine the utility of these biomarkers in clinical practice. Also, while overall adherence to local COPD guidelines was good, there is scope for improvement in performing spirometry and provision of NIV to eligible patients.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent1958191 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.publisherMedknow Publications and Media Pvt. Ltd.
dc.publisher.placeIndia
dc.publisher.uriHttp://www.journalonweb.com/jrms/
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom297
dc.relation.ispartofpageto303
dc.relation.ispartofissue4
dc.relation.ispartofjournalJournal of Research in Medical Sciences
dc.relation.ispartofvolume19
dc.rights.retentionY
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchcode119999
dc.subject.fieldofresearchcode11
dc.titleEmergency department management of acute exacerbations of chronic obstructive pulmonary disease and factors associated with hospitalization
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2014 Journal of Research in Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorKeijzers, Gerben
gro.griffith.authorSivakumaran, Pathmanathan
gro.griffith.authorSriram, Krishna K.


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