Korean J Adult Nurs.  2019 Aug;31(4):427-438. 10.7475/kjan.2019.31.4.427.

Comparisons of the Characteristics for Non-hospitalized, Hospitalized, and Rehospitalized Patients due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Affiliations
  • 1Professor, College of Nursing, Chonnam National University, Gwangju, Korea.
  • 2Assistant Professor, Department of Nursing, Nambu University, Gwangju, Korea. yunsy@nambu.ac.kr

Abstract

PURPOSE
This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review.
METHODS
From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression.
RESULTS
Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups.
CONCLUSION
Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.


MeSH Terms

Adrenal Cortex Hormones
Cyclic Nucleotide Phosphodiesterases, Type 4
Dyspnea
Education
Fever
Hospitalization
Humans
Jeollanam-do
Logistic Models
Medical Records
Metered Dose Inhalers
Nursing
Nursing, Practical
Oxygen
Patient Readmission
Positive-Pressure Respiration
Prescriptions
Pulmonary Disease, Chronic Obstructive*
Respiratory Function Tests
Retrospective Studies
Adrenal Cortex Hormones
Cyclic Nucleotide Phosphodiesterases, Type 4
Oxygen
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