Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Chronic obstructive pulmonary disease exacerbations’ management in Portuguese hospitals – EvaluateCOPDpt, a multicentre, observational, prospective study,” published in the November 2024 issue of Pulmonology by Moita et al. 

Improved knowledge of clinical practices and factors influencing patient outcomes was needed to enhance the care of patients with chronic obstructive pulmonary disease (COPD).  

Researchers conducted a retrospective study to assess the relationship between clinical practice and outcomes of patients admitted for COPD exacerbations in Portuguese hospitals.  

They performed a study with a 60-day follow-up period across 11 hospitals, including patients aged ≥30 years who were admitted for at least 24 hours due to an acute exacerbation of COPD. Data collected included demographics, smoking habits, prior hospitalizations, pulmonary function, comorbidities, COPD symptoms, and treatment details. A structured phone follow-up interview was conducted 60 days post-discharge to assess COPD management, outcomes, and readmission information.  

The results showed that 196 patients (85.7% male, mean age 71.2 years) were included, primarily admitted through the emergency service. Over half were ex-smokers (51%) or current smokers (36%). On admission, most were on long-acting muscarinic receptor antagonists (LAMA) (72.4%), long-acting β2-adrenoceptor (LABA) (54.6%), or LABA/LAMA (45.5%). A significant proportion of the population used Inhaled corticosteroids (ICS) (37.3%) and systemic steroids (SCS) (10.3%). Nearly 40% had recent exacerbations. Spirometry data was missing for over 20%. During hospitalization, 98.5% received oxygen and non-invasive ventilation (38.3%). Nearly all used SCS (93.4%) and ICS (60.2%), and over 80% received antibiotics. At discharge, most were prescribed LAMA (79.1%), SCS (63.6%), LABA (61.5%), LAMA+LABA (55.6%), or ICS+LABA+LAMA (26.2%). Within 60 days, 44.4% had a scheduled appointment, and 28.3% were readmitted due to exacerbation, with over half requiring hospitalization.  

Investigators concluded that understanding the management of COPD exacerbations in acute hospital admissions in Portugal can inform national discussions and policy reviews to improve patient outcomes and reduce healthcare costs. 

Source: sciencedirect.com/science/article/pii/S2531043722001556