Management of chronic obstructive pulmonary disease exacerbations at the Nasser Medical Complex: a clinical audit

Publication date: 21 February 2018 Source:The Lancet, Volume 391, Supplement 2 Author(s): Maha Al-Faqawi, Yousef Abuowda, Alaa Eldeen Elmassry, Bettina Böttcher Background The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD 2015). Methods We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016. Clinical practice was compared with GOLD guidelines. Ethical approval was obtained from the General Directorate of Human Resources. Findings 55 patient records were reviewed. The mean age was 66·4 years (SD 8·5), and 54 (98%) patients were male. All patients received inhaled bronchodilators. 36 (65%) patients received short-acting β agonists (SABA), 43 (78%) received short-acting muscarinic agonists (SAMA), 13 (24%) received long-acting muscarinic agonists (LAMA), one (2%) received long-acting beta-agonists (LABA), and 22 (40%) received both SABA and SAMA. 53 (96%) patients received systemic corticosteroids. 43 (78%) patients took more than the recommended 40 mg prednisolone daily. Only 12 (22%) patients received prednisolone as...
Source: The Lancet - Category: General Medicine Source Type: research