Chest
Original ResearchCOPDImportance of Noninvasively Measured Respiratory Muscle Overload Among the Causes of Hospital Readmission of COPD Patients
Section snippets
Patients
All of the patients with moderate-to-severe COPD (112 subjects), who were admitted consecutively to a hospital ward between January 2004 and December 2004 for an acute exacerbation of COPD, were included in this study. The patients had COPD confirmed by a medical history including current smoking status or smoking history (ie, history of > 10 pack-years), clinical evaluation, and pulmonary functional testing results showing airflow obstruction (ie, FEV1/FVC ratio < 70) with a change in FEV1 of
Results
The characteristics of the study patients at hospital discharge are shown in Table 1. All patients were men with a mean age of 69.3 ± 7.5 years. The smoking history for the whole group was evaluated at 75 ± 40 pack-years. Airway obstruction was moderate to severe because the mean FEV1 was 43 ± 12% predicted. The group as a whole showed moderate hypoxemia (mean Pao2, 62.7 ± 9.1 mm Hg) and hypercapnia (mean Paco2, 48.01 ± 8.4 mm Hg). Nevertheless, 27 of the 112 patients had a Pao2 of < 60 mm Hg
Discussion
The main findings of our study show that high respiratory muscle load assessed by means of the PTI and treated with LTOT are independent predictive factors for hospital readmission in patients with moderate-to-severe COPD. Cardiac overload assessed by an elevated estimate of SPAP also appears to be a predictive factor, but the low number of patients who had undergone an echo-Doppler examination greatly detracted from the clinical relevance of this statistical finding.
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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.