Quality of Life Research

, 18:191 | Cite as

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

  • Chu-Lin Tsai
  • Brian H. Rowe
  • Carlos A. CamargoJr.
Article

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 

Notes

Acknowledgments

The authors thank the EMNet investigators for their ongoing dedication to public health research, with an emphasis on the treatment and prevention of respiratory/allergy emergencies.

EMNet Steering Committee: Adit A. Ginde, MD, MPH; Edwin D. Boudreaux, PhD; Carlos A. Camargo, Jr., MD, DrPH (Chair); Jonathan M. Mansbach, MD; Steven Polevoi, MD; Michael S. Radeos, MD, MPH; and Ashley F. Sullivan, MS, MPH.

EMNet Coordinating Center: Angela Anderson; Carlos A. Camargo, Jr., MD (Director); Kate Delaney; Lisa A. Dubois; Janice Espinola, MPH; Jessica Pang; Ashley F. Sullivan, MS, MPH; and Chu-Lin Tsai, MD, MPH—all at Massachusetts General Hospital, Boston.

Principal Investigators at the 29 Participating Sites: F.C. Baker III (Maine Medical Center, Portland, ME); M.P. Blanda (Summa Health System, Akron, OH); E.D. Boudreaux (Earl K. Long Memorial Hospital, Baton Rouge, LA); B.E. Brenner (The Brooklyn Hospital Center, Brooklyn, NY); C.A. Camargo Jr. (Massachusetts General Hospital, Boston, MA); R.K. Cydulka (MetroHealth Medical Center, Cleveland, OH); T.J. Gaeta (New York Methodist Hospital, Brooklyn, NY); B. Goldfeder (Shands Hospital at the University of Florida, Gainesville, FL); R.J. Grant (Hartford Hospital, Hartford, CT); R.O. Gray (Hennepin County Medical Center, Minneapolis, MN); A. Guttman (Sir Mortimer B. Davis–Jewish General Hospital, Montreal, QC); L.W. Kreplick (Christ Hospital & Medical Center, Oak Lawn, IL); D.S. Mackey (Lethbridge Regional Hospital, Lethbridge, AB); A. Mangione (Albert Einstein Medical Center, Philadelphia, PA); J. Peters (University of Texas Health Sciences Center at San Antonio, San Antonio, TX); M.S. Radeos (Lincoln Medical Center, Bronx, NY); P.L. Rice (Brigham and Women’s Hospital, Boston, MA); B.H. Rowe (University of Alberta Hospital, Edmonton, AB); M. Sama (St. Joseph Mercy Hospital, Ann Arbor, MI); D. Schreiber (Stanford University Medical Center, Stanford, CA); N.I. Shapiro (Beth Israel Deaconess Medical Center, Boston, MA); P.C. Shukla (University of Texas Southwestern Medical Center, Dallas, TX); D. Sinclair (Queen Elizabeth II Health Science Centre (Halifax, NS); H. Smithline (Baystate Medical Center, Springfield, MA); P.E. Sokolove (UC Davis Medical Center, Sacramento, CA); M. Steffens (Palmetto Richland Memorial Hospital, Columbia, SC); C.A. Terregino (Cooper Hospital/University Medical Center, Camden, NJ); A. Travers (Royal Alexandria Hospital, Edmonton, AB); and E.J. Weber (UCSF Medical Center, San Francisco, CA).

Funding: The cohort studies were supported by an unrestricted grant from Boehringer Ingelheim (Ridgefield, CT, USA and Burlington, Ontario, Canada).

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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Chu-Lin Tsai
    • 1
    • 2
  • Brian H. Rowe
    • 3
  • Carlos A. CamargoJr.
    • 1
    • 2
  1. 1.Department of Emergency MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  3. 3.Department of Emergency MedicineUniversity of AlbertaEdmontonCanada

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