RESUMO
No disponible
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/sangue , Anemia/epidemiologia , Policitemia/epidemiologia , Biomarcadores/análise , Fatores de Risco , Doença Pulmonar Obstrutiva Crônica/complicaçõesRESUMO
OBJECTIVE: We carried out a randomized controlled trial to evaluate the efficacy of a home hospitalization (HH) program for patients hospitalized for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Patients who were clinically stable and had stable arterial blood gases were randomized to the conventional hospitalization group or the HH group. RESULTS: Of the 88 patients evaluated, 40 (20 in each group) were enrolled. No differences were observed in baseline characteristics, in clinical recovery, or arterial blood gases between the 2 groups at discharge. At 1-month follow up there were no differences in mortality or in the number of readmissions. The mean length of hospitalization in patients with HH was 9.2 days (4 days in hospital and 5 days at home), compared to 12.2 days in patients with conventional hospitalization. CONCLUSIONS: Our results show that a hospital-supervised HH program including the participation of pneumologists and nursing staff allows for the recovery of patients hospitalized for exacerbation of COPD who have stable symptoms and arterial blood gases with no increase in the rate of readmission, relapse, or therapeutic failure.
Assuntos
Serviços Hospitalares de Assistência Domiciliar , Doença Pulmonar Obstrutiva Crônica/terapia , Idoso , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de SaúdeRESUMO
OBJETIVO: Se ha realizado un estudio prospectivo, controlado y aleatorizado en grupos paralelos con el fin de evaluar la eficacia de un programa de hospitalización domiciliaria (HD) en pacientes ingresados en el hospital por agudización de la enfermedad pulmonar obstructiva crónica (EPOC). PACIENTES Y MÉTODOS: Los pacientes que cumplían criterios de estabilidad clínica y gasométrica al tercer día se aleatorizaron al grupo de hospitalización convencional o al grupo HD. RESULTADOS: De los 88 pacientes valorados se incluyó a 40 (20 en cada grupo). No se apreciaron diferencias en las características basales, en la recuperación clínica ni en la gasometría al alta entre ambos grupos. Al mes de seguimiento no hubo diferencias en la mortalidad ni en el número de readmisiones. La estancia media de los pacientes con HD fue de 9,2 días (4 días en el hospital y 5 días en su domicilio), frente a los 12,2 días que permanecieron los pacientes en el hospital. CONCLUSIONES: Nuestros resultados demuestran que un programa de HD controlado desde el hospital, con participación de neumólogos y personal de enfermería, en enfermos ingresados con exacerbación de la EPOC que cumplen unos requisitos de estabilidad clínica y gasométrica, permite la recuperación del paciente sin un aumento en la tasa de reingresos, recaídas o fracasos terapéuticos
OBJECTIVE: We carried out a randomized controlled trial to evaluate the efficacy of a home hospitalization (HH) program for patients hospitalized for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Patients who were clinically stable and had stable arterial blood gases were randomized to the conventional hospitalization group or the HH group. RESULTS: Of the 88 patients evaluated, 40 (20 in each group) were enrolled. No differences were observed in baseline characteristics, in clinical recovery, or arterial blood gases between the 2 groups at discharge. At 1-month follow up there were no differences in mortality or in the number of readmissions. The mean length of hospitalization in patients with HH was 9.2 days (4 days in hospital and 5 days at home), compared to 12.2 days in patients with conventional hospitalization. CONCLUSIONS: Our results show that a hospital-supervised HH program including the participation of pneumologists and nursing staff allows for the recovery of patients hospitalized for exacerbation of COPD who have stable symptoms and arterial blood gases with no increase in the rate of readmission, relapse, or therapeutic failure
Assuntos
Idoso , Humanos , Serviços Hospitalares de Assistência Domiciliar , Doença Pulmonar Obstrutiva Crônica/terapia , Apoio à Pesquisa como Assunto , Avaliação de Programas e Projetos de SaúdeAssuntos
Assistência Domiciliar , Respiração Artificial , Desenho de Equipamento , Seguimentos , Assistência Domiciliar/normas , Humanos , Pneumopatias Obstrutivas/enfermagem , Pneumopatias Obstrutivas/terapia , Transtornos Respiratórios/enfermagem , Transtornos Respiratórios/terapia , Respiração Artificial/instrumentação , Respiração Artificial/métodos , Respiração Artificial/enfermagem , Respiração Artificial/normas , Testes de Função Respiratória , Síndromes da Apneia do Sono/enfermagem , Síndromes da Apneia do Sono/terapia , Traqueostomia/enfermagem , Ventiladores MecânicosRESUMO
No disponible
Assuntos
Humanos , Respiração Artificial , Assistência Domiciliar , Síndromes da Apneia do Sono , Traqueostomia , Transtornos Respiratórios , Ventiladores Mecânicos , Desenho de Equipamento , Seguimentos , Testes de Função Respiratória , Pneumopatias ObstrutivasRESUMO
To estimate the interobserver variability and degree of agreement for basic spirometric parameters before beginning field work for the IBERPOC Project. Study of agreement between 7 observers (pneumologists) and a gold standard, using a scheme of incomplete balanced and randomized blocks with an equal number of spirometric measurements (n = 3) per patient and an equal number of measurements (n = 9) per observer performed at the same session. The study population consisted of 14 patients with different degrees of air flow obstruction and 7 normal volunteers. Statistically significant differences attributable to subjects (inter-patient variability) were found for the three variables analyzed. Variability attributable to the observer was found for FVC and FEV1 but not for FEV1/FVC. The greatest interobserver differences were found for FEV1, such that 4 of the 7 observers recorded values that were significantly different from the mean (p < 0.05). The differences were less marked for FVC and for the FEV1/FVC ratio, with only 2 observers recording significantly different values for each variable. The high degree of reproducibility as well as the excellent interobserver agreement found in this standardization session provide an a priori guarantee of validity for spirometric measurements and rule out the existence of differential bias in data recorded at the various geographic areas involved in the study.
