Show simple item record

dc.contributor.authorQuintana López, José María
dc.contributor.authorEsteban, Cristóbal
dc.contributor.authorUnzurrunzaga, Anette
dc.contributor.authorGarcia-Gutierrez, Susana
dc.contributor.authorGonzález, Nerea
dc.contributor.authorBarrio Beraza, Irantzu
dc.contributor.authorArostegui Madariaga, Inmaculada
dc.contributor.authorLafuente Guerrero, Iratxe
dc.contributor.authorBaré Mañas, Marisa
dc.contributor.authorFernandez-de-Larrea, Nerea
dc.contributor.authorVidal, Silvia
dc.date.accessioned2016-01-29T13:02:05Z
dc.date.available2016-01-29T13:02:05Z
dc.date.issued2014-04-23
dc.identifier.citationBMC Medicine 12 : (2014) // Article ID 66es
dc.identifier.issn1741-7015
dc.identifier.urihttp://hdl.handle.net/10810/17069
dc.description.abstractBackground: Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods: This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results: In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better. Conclusions: Five clinical predictors easily available in the ED, and also in the primary care setting, can be used to create a simple and easily obtained score that allows clinicians to stratify patients with eCOPD upon ED arrival and guide the medical decision-making process.es
dc.description.sponsorshipThis work was supported in part by grants from the Fondo de Investigacion Sanitaria (PI 06\1010, PI06\1017, PI06\714, PI06\0326, PI06\0664); Department of Health of the Basque Country, Department of Education, Universities and Research of the Basque Government (UE09/62); the Research Committee of the Hospital Galdakao; and the thematic networks-Red IRYSS (Investigacion en Resultados y Servicios Sanitarios (G03/220))- of the Instituto de Salud Carlos III.es
dc.language.isoenges
dc.publisherBiomed Centrales
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.subjectCOPD exacerbationses
dc.subjectmortalityes
dc.subjectprediction rulees
dc.subjectprospective cohort studyes
dc.subjectrisk analysises
dc.subjectstructurees
dc.subjectobstructive pulmory-diseasees
dc.subjectclinical-featureses
dc.subjectrisk-scorees
dc.subjectvalidationes
dc.subjectburdenes
dc.subjectdiagnosises
dc.subjectmetaanalysises
dc.subjectpreventiones
dc.subjectmanagementes
dc.subjectseverityes
dc.titlePredictive score for mortality in patients with COPD exacerbations attending hospital emergency departmentses
dc.typeinfo:eu-repo/semantics/articlees
dc.rights.holder© 2014 Quintana et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.es
dc.relation.publisherversionhttp://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-66#Abs1es
dc.identifier.doi10.1186/1741-7015-12-66
dc.departamentoesMatemática aplicadaes_ES
dc.departamentoeuMatematika aplikatuaes_ES
dc.subject.categoriaMEDICINE


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record