Abstract：
AIMS:To validate a previously developed set of explicit criteria for the appropriateness of hospital admission among these patients using the RAND/UCLA Appropriateness Methodology (RAM). METHODS:We conducted a prospective cohort study of patients experiencing symptoms of COPD exacerbation seen in the emergency departments (ED) of 16 hospitals belonging to the Spanish National Health Service. Sociodemographic and clinical variables needed to assess appropriateness were recorded. Main outcomes were mortality, severe COPD evolution, complications at follow up, and three patient-reported measures: dyspnoea level, capacity for physical activity and perceived health status. RESULTS:Appropriately admitted patients were more likely to die (6.70% vs. 2.68%, p = 0.0102) than inappropriately admitted patients, and were more likely to develop severe evolution (27.09% vs. 6.08%, p < 0.0001) and complications (18.72% vs. 11.92%, p = 0.0244). Among discharged patients, no significant differences were observed in clinical outcomes. All patients exhibited worse dyspnoea and capacity for physical activity after exacerbation, but changes among appropriately admitted patients were less than among appropriately discharged patients. CONCLUSION:Our appropriateness criteria identified patients in worse condition at ED arrival who were more likely to benefit from admission in terms of mortality and COPD evolution.
journal_name
Int J Clin Practjournal_title
International journal of clinical practiceauthors
Garcia-Gutierrez S,Quintana JM,Bilbao A,Unzurrunzaga A,Esteban C,Baré M,Girón Moreno RM,Pulido E,Rivas P,IRYSS-COPD Appropriateness Study (IRYSS-COPD) Group.doi
10.1111/ijcp.12397subject
Has Abstractpub_date
2014-07-01 00:00:00pages
820-9issue
7eissn
1368-5031issn
1742-1241journal_volume
68pub_type
杂志文章abstract：:Gastric acid is pathogenic in many gastrointestinal disorders, such as gastroesophageal reflux disease and peptic ulcer disease. Proton pump inhibitors (PPIs) are the antisecretory drugs of choice for serious acid-related conditions. Ample recent data exist to explicate virtually every aspect of the clinical managemen...
journal_title：International journal of clinical practice
pub_type： 杂志文章,评审
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journal_title：International journal of clinical practice
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abstract：:A 43-year-old female patient with Basedow-Graves' disease developed agranulocytosis in the eighth month of propylthiouracil therapy. After discontinuing the drug, a broad spectrum antibiotic regimen plus recombinant human granulocyte colony-stimulating factor (G-CSF), a human haematopoietic growth factor, were started...
journal_title：International journal of clinical practice
pub_type： 杂志文章
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journal_title：International journal of clinical practice
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：International journal of clinical practice
pub_type： 杂志文章
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journal_title：International journal of clinical practice
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doi：
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journal_title：International journal of clinical practice
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doi：10.1111/ijcp.12485
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journal_title：International journal of clinical practice
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journal_title：International journal of clinical practice
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journal_title：International journal of clinical practice
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pub_type： 杂志文章
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journal_title：International journal of clinical practice
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doi：
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journal_title：International journal of clinical practice
pub_type： 杂志文章,多中心研究,随机对照试验
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journal_title：International journal of clinical practice
pub_type： 杂志文章,评审
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journal_title：International journal of clinical practice
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journal_title：International journal of clinical practice
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doi：
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journal_title：International journal of clinical practice
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doi：
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journal_title：International journal of clinical practice
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journal_title：International journal of clinical practice
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journal_title：International journal of clinical practice
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doi：
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