RESUMO
A prolonged hospital length of stay during an episode of exacerbation of chronic obstructive pulmonary disease is a condition that increases the risk of suffering associated medical complications. Objective: The objective of this study was to determine the factors associated with a prolonged hospital length of stay in exacerbations of chronic obstructive pulmonary disease through a prediction model. Materials and Methods: In a cross-sectional study we gathered the data of the medical records of a hospital located in the Eastern region of Colombia, between years 2012 and 2014. We carried out a descriptive, bivariate and multivariate analysis. Results: A total of 212 patients were included in this study. 61.32% showed a prolonged hospital length of stay. We found a significant statistical association between the prolonged hospital stay and the independent variables of the bivariate analysis: dyspnea (OR [Odds Ratio]: 2.87 p = 0.04), fever (OR: 2; p = 0.02), inpatient oxygen (OR: 2.34, p = 0.003), inpatient anticholinergics (OR: 2.91, p = 0.002), inpatient antibiotic (OR: 2.25, p= 0.004), segs (OR: 1.02, p= 0.01) and lymphocytes (OR: 0.95, p = 0.003). The predictive model had a p value of 0.4950 in the analysis of goodness (Pearson Test) and a p value of 0.2689 in the goodness of fit test (Hosmer-Lemeshow Test), indicating an adequate fit. Also, the model showed an area under the curve of 0.6588. Conclusions: Our prediction model included the following variables: age, anticholinergics and segs, for their significant association. It has an adequate fit and a good pattern of prediction.
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica , Hospitais , Tempo de InternaçãoRESUMO
We ascertained whether a public health stroke unit reduces the length of hospitalization, the rate of inpatient fatality, and the mortality rate 30 days after the stroke. Methods We compared a cohort of stroke patients managed on a general neurology/medical ward with a similar cohort of stroke patients managed in a str oke unit. The in-patient fatality rates and 30-day mortality rates were analyzed. Results 729 patients were managed in the general ward and 344 were treated at a comprehensive stroke unit. The in-patient fatality rates were 14.7% for the general ward group and 6.9% for the stroke unit group (p<0.001). The overall mortality rate 30 days after stroke was 20.9% for general ward patients and 14.2% for stroke unit patients (p=0.005). Conclusions We observed reduced in-patient fatalities and 30-day mortality rates in patients managed in the stroke unit. There was no impact on the length of hospitalization. .
Avaliar o impacto da unidade de AVC (acidente vascular cerebral) no sistema público de saúde sobre o tempo de internação, mortalidade hospitalar e mortalidade após 30 dias do AVC agudo. Métodos Comparamos uma coorte de pacientes com AVC agudo tratados em enfermaria neurológica ou geral (EG) com uma coorte similar de pacientes com AVC tratados em uma unidade de AVC (UAVC), em um mesmo hospital público. Resultados 729 pacientes foram conduzidos na EG e 344 foram tratados em uma UAVC. A mortalidade inicial foi de 14,7% na EG e 6,9% na UAVC (p<0,001). A mortalidade geral em 30 dias após o AVC foi de 20.9% nos pacientes tratados na EG e 14,2% naqueles tratados na UAVC (p=0,005). Conclusão Observamos significante redução da mortalidade inicial e da mortalidade após 30 dias do AVC nos pacientes tratados na UAVC. Não houve impacto sobre o tempo de internação. .