Association Between Initiation of Pulmonary Rehabilitation and Rehospitalizations in Patients Hospitalized with COPD
Am J Respir Crit Care Med. 2021 Jul 20. doi: 10.1164/rccm.202012-4389OC. Online ahead of print.ABSTRACTRATIONALE: Althoughl clinical trials have found that pulmonary rehabilitation (PR) can reduce the risk of readmissions following hospitalization for a COPD exacerbation, less is known about PR's impact in routine clinical practice.OBJECTIVE: We evaluated the association between initiation of PR within 90 days of discharge and rehospitalization(s).METHODS: We analyzed a retrospective cohort of Medicare beneficiaries (≥ 66 years) hospitalized for COPD in 2014 who survived at least 30 days following discharge.MEASUREMENTS: We used propensity score (PS) matching and estimated the risk of recurrent all-cause rehospitalizations at one year using a multi-state model to account for the competing risk of death.MAIN RESULTS: Of 19,376 patients hospitalized in 4,446 hospitals, 2,721 patients (1.5%) initiated PR within 90 days of discharge. Overall, 1,534 (56.4%) of patients who initiated PR and 125,720 (64.6%) who did not were rehospitalized one or more times within one year of discharge. In the PS matched analysis, PR initiation was associated with a lower risk of readmission in the year following PR initiation (Hazard Ratio: 0.83; 95% CI: 0.77 - 0.90). The mean cumulative number of rehospitalizations at one year was 0.95 for those who initiated PR within 90 days and 1.15 for those who did not (p
ConclusionsNot only is the number of CD8 + T-cells increased in COPD, these cells have increased capacity to exert effector functions and are likely to contribute to disease pathogenesis. Several mechanisms highlighted show promise for future investigation to consolidate current knowledge.
This study was conducted on a sample of 42 COPD subjects with patient history, COPD assessment test (CAT) and spirometry. 5STST performance time and the number 30s-STST repetitions showed differences of statistical significance in COPD subjects considered to be more symptomatic and in subjects with high risk of future exacerbations. Both STSTs correlated significantly with forced expiratory volume in one second % predicted (FEV1%), CAT, number of acute exacerbations in the past year and number of hospitalized exacerbations in the past year. STST performance correlates significantly with items of the CAT questionnaire that ...
Publication date: Available online 8 October 2020Source: Respiratory Physiology &NeurobiologyAuthor(s): Vlasios Skopas, Dimitrios Papadopoulos, Nikolaos Trakas, Eleni Papaefstathiou, Charalampos Koufopoulos, Demosthenes Makris, Zoe Daniil, Konstantinos Gourgoulianis
Conclusion: The current study provides the first evidence regarding the status of frailty in older Chinese adults with hypertension.
Authors: Utley C, Gold MH, Hall M Abstract Background/Significance of problem: Atopic Dermatitis (AD) is a common, chronic, inflammatory dermatosis and skin disease that follows a relapsing pattern and requires a dynamic stepwise approach to management.Providers feel comfortable treating chronic disease states with a guided tool or care plan in many chronic diseases.Care plans used in many chronic diseases such as asthma, diabetes, and COPD have demonstrated effectiveness in disease and healthcare provider management.There is an unmet need for a universal AD care plan for providers. Clinical question/project purpos...
Elderly patients with impaired vision, cognitive decline or motor/sensory disturbances of their fingers suffering from chronic-obstructive pulmonary disease (COPD) encounter difficulties in handling inhaler de...
Gastrointestinal symptoms are prevalent extrapulmonary systemic manifestations of Chronic Obstructive Pulmonary Disease (COPD), but have been rarely studied. We dissected the perturbations in intestinal function in human patients with COPD using comprehensive metabolic and physiological approaches.
ConclusionPressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.
npj Primary Care Respiratory Medicine, Published online: 09 October 2020; doi:10.1038/s41533-020-00198-5Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice
Conditions: COPD; Chronic Obstructive Pulmonary Disease Interventions: Other: 1-min STS test: adjusted; Other: 1-min STS test: standardized Sponsors: Thomas Riegler; University of Zurich Recruiting