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만성폐쇄성폐질환 비입원 환자와 급성악화로 입원, 재입원하는 환자특성 비교

Comparisons of the Characteristics for Non-hospitalized, Hospitalized, and Rehospitalized Patients due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

성인간호학회지 2019년 31권 4호 p.427 ~ 438

Abstract


Purpose: This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review.

Methods: From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression.

Results: Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups.

Conclusion: Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.

키워드

만성폐쇄성폐질환; 재입원; 의무기록; 간호실무
Pulmonary disease, chronic obstructive; Patient readmission; Medical records; Nursing, practical
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