The aim of study was to evaluate the adequacy of diagnosis and management of respiratory failure (RF) in COPD.
METHODS: Retrospective analysis of the Hospital Discharge Forms of COPD patients hospitalised for RF from January 2007 to June 2008. Using the clinical audit tool, the primary end-point was the accuracy of RF diagnosis. The secondary end-points were mortality, re-hospitalisation rate, length of hospital stay, accuracy of long-term oxygen therapy (LTOT) prescription, agreement of the treatments with the GOLD 2008 guidelines. Statistical analysis used Pearson and Spearman correlation test and Cohen's kappa for degree of agreement. Differences in demographics and clinical parameters were analyzed with χ²-test, t-test or Fisher?s test, as appropriate.
RESULTS: 130 patients were studied, 80 males (62%), mean age 76.6 ± 9.1 (SD) years. Arterial blood gas analysis (ABG) was performed in 118 patients (90.8%) and in 77 (81%) a PaO₂ < 60 mmHg was found at admission. Of these, 42 cases (54.5%) had no diagnosis of RF despite a PaO₂ < 60 mmHg. In 18 (19%) PaO₂ was > 60 mmHg; of these, 6 cases (33.3%) received an incorrect RF diagnosis.
Authors: Menzella F, Facciolongo N, Lusuardi M, Piro R, Formisano D, Castagnetti C, Simonazzi A, Zucchi L
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