[ASSIMILATING PROMS DURING AND POST-HOSPITALIZATION OF COPD PATIENTS DUE TO DISEASE EXACERBATION MAY IMPROVE THEIR CLINICAL FOLLOW-UP - A CLINICAL, PROSPECTIVE, OBSERVATIONAL STUDY].

Autor:	Muhsen A; Internal Medicine T, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University., Lasman N; Internal Medicine T, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University., Turpashvili N; Internal Medicine T, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University., Berger G; Internal Medicine B, Rambam Medical Center, Haifa.; Rapaport Faculty of Medicine. Technion, Haifa., Ari-Am S; Internal Medicine T, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University., Akuka A; Internal Medicine B, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine. Tel-Aviv University., Saad T; Internal Medicine B, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine. Tel-Aviv University., Galper A; Management Wing, Chaim Sheba Medical Center, Tel-Hashomer. Ramat Gan., Zimlichman E; Management Wing, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University., Segal G; Internal Medicine T, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan.; Sackler Faculty of Medicine, Tel-Aviv University.
Jazyk:	hebrejština
Zdroj:	Harefuah [Harefuah] 2021 Aug; Vol. 160 (8), pp. 520-526.
Abstrakt:	Background: Chronic obstructive pulmonary disease (COPD) exacerbations necessitating hospitalization are known to have a negative impact on post-discharge clinical outcomes. In the present study, we evaluated the potential benefits in applying Patient-Reported-Outcome-Measures (PROMS) in order to better these patients' post-hospitalization prognostication. Methods: This was a prospective, observational study. Results: Ninety-nine COPD patients were recruited (aged 9.7±73 years, 61.6% males). All patients filled two separate PROMS (EXACT & PROMIS GLOBAL 10) while 69 of them also filled a second battery of PROMS within 3 months post discharge. The median follow-up time was 14.3 months. The patients' characteristics found to have a statistically significant association with increased risk for 90-days re-hospitalization were: permanent use of oxygen at home [55.2% vs. 32.8%, p=0.045]; significant change in the dyspnea score of the EXACT [54(40-71) vs. 38(11-60), OR=1.115; 95CI 1.006-1.236, p=0.038] and significant change in the cough and sputum, score section of the EXACT [0 (-19-25) vs. -14 (-31-0), OR=1.095; 95CI 1.011-1.187, p=0.027]. Patients' characteristics found to have a statistically significant association with increased risk for 90-days mortality were: age [83±8.43 vs. 72.46±9.53, p=0.047], diagnosis of pneumonia during index hospitalization [60% vs. 14.9%, P=0.034] and low ALT blood activity [10IU (5.5-13.8) vs. 17IU (13-22.8), p=0.016]. Significant change in the EXACT score was associated with increased risk of long-term mortality [-3 (-8.8-9.5) vs. -9 (-21.5-0), OR=1.047; CI95% 1.005-1.091, p=0.03]. Conclusions: Assimilating PROMS, during and post-hospitalization due to COPD exacerbation could improve our prediction for negative clinical outcomes, both short- and long-term. This may offer better therapeutic interventions in the future. We recommend usage of the EXACT as part of the post-discharge follow-up of COPD patients.
Databáze:	MEDLINE
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