Multicentre audit of inpatient management of acute exacerbations of chronic obstructive pulmonary disease: comparison with clinical guidelines.

摘要: Background and objective:  Chronic obstructive pulmonary disease (COPD) exacerbations are a major cause of hospital admission clinical guidelines for optimised management available. However, few data assessing concordance with these We aimed to identify gaps document variability in practices COPD admissions. Methods:  Medical records all admissions over 3-month period as non-catastrophic or severe comorbidities complications at eight acute-care hospitals within the Hunter New England region were retrospectively audited. Results:  Mean (SD) length stay was 6.3 (6.1) days 221 mean age 71 (10), 53% female 34% current smokers. Spirometry performed wide inter-hospital range (4–58%, P < 0.0001): FEV1 36% (18) predicted. Arterial blood gases on 54% cases (range 0–85%, 0.0001). Parenteral steroids used 82% admissions, antibiotics 87% oxygen therapy during 79% (with prescription only 3% these). Bronchodilator converted from nebuliser an inhaler device 51% early 1.6 (1.7) days. Only 22% patients referred rehabilitation (inter-hospital 0–50%, P= 0.002). Re-admission 28 days higher rural compared metropolitan (27% vs 7%, 0.0001). Conclusions:  identified best practice service provision associated variations, indicating disparity access services throughout region.