Article

Quality of Life Research

, Volume 18, Issue 2, pp 191-199

Factors associated with short-term recovery of health status among emergency department patients with acute exacerbations of chronic obstructive pulmonary disease

  • Chu-Lin TsaiAffiliated withDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical SchoolDepartment of Epidemiology, Harvard School of Public Health Email author 
  • , Brian H. RoweAffiliated withDepartment of Emergency Medicine, University of Alberta
  • , Carlos A. CamargoJr.Affiliated withDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical SchoolDepartment of Epidemiology, Harvard School of Public Health

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Abstract

Objective

To determine the factors associated with short-term recovery of health status following chronic obstructive pulmonary disease (COPD) exacerbation.

Methods

In a prospective multicenter cohort study, consecutive emergency department (ED) patients with COPD exacerbation were enrolled. Patients were interviewed and instructed to complete the validated Short Form Chronic Respiratory disease Questionnaire. Follow-up data were collected 2 weeks later, and included the global transition question. The primary outcome was recovery of health status, which was assigned to patients who stated that their COPD was “a little better” or “much better” than at the time of their ED presentation.

Results

Of the 330 patients, 270 [82%; 95% confidence interval (CI), 77–86%] reported recovery of health status following acute exacerbations. Multivariable analysis showed that recovery of health status was associated with having a primary care provider (PCP) [odds ratio (OR), 3.1; 95% CI, 1.5–6.4] and a co-diagnosis of asthma (OR, 2.2; 95% CI, 1.2–3.8). By contrast, frequent exacerbations (two or more exacerbations in the past year) (OR, 0.4; 95% CI, 0.2–0.7) was inversely associated with recovery.

Conclusions

Reducing exacerbation frequency and provision of adequate PCP follow-up after ED visit may help improve the recovery of health status following acute exacerbations of COPD.

Keywords

Chronic obstructive pulmonary disease Emergency department Exacerbation Health status Recovery