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Risk Factors of Readmission in Acute Exacerbation of Moderate-to-Severe Chronic Obstructive Pulmonary Disease
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Nebot, Z. Tomás, C. Ariza, S. Valmayor, M.J. López, O. Juárez" "autores" => array:6 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "M." "apellidos" => "Nebot" ] 1 => array:2 [ "nombre" => "Z." "apellidos" => "Tomás" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Ariza" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Valmayor" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "López" ] 5 => array:2 [ "nombre" => "O." "apellidos" => "Juárez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603649?idApp=UINPBA00003Z" "url" => "/15792129/0000004000000011/v1_201305141823/S1579212906603649/v1_201305141823/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Risk Factors of Readmission in Acute Exacerbation of Moderate-to-Severe Chronic Obstructive Pulmonary Disease" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "502" "paginaFinal" => "507" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. González, E. Servera, G. Ferris, M.L. Blasco, J. Marín" "autores" => array:5 [ 0 => array:5 [ "preGrado" => "Dra" "nombre" => "C." "apellidos" => "González" "email" => array:1 [ 0 => "cruz.gonzalez@uv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Servera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Ferris" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "M.L." "apellidos" => "Blasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "J." "apellidos" => "Marín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad Coronaria, Servicio de Medicina Intensiva, Hospital Clínico Universitario, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. C. González. Servicio de Neumología. Hospital Clínico Universitario. Avda. Blasco Ibáñez, 17. 46010 Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-12-12" "fechaAceptado" => "2004-04-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153179" "palabras" => array:5 [ 0 => "Chronic obstructive pulmonary disease (COPD)" 1 => "Exacerbation" 2 => "Readmission" 3 => "Inspiratory load" 4 => "Pressure-time index" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153178" "palabras" => array:5 [ 0 => "EPOC" 1 => "Agudización" 2 => "Reingreso" 3 => "Carga inspiratoria" 4 => "Índice presión-tiempo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">More effective management of chronic obstructive pulmonary disease (COPD) and improved survival of COPD patients requires a better understanding of the risk factors for exacerbation. The aim of this study was to identify factors related to readmission in patients with moderate-to-severe COPD.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Ninety patients with moderate-to-severe COPD hospitalized consecutively for acute exacerbation were studied prospectively. At discharge, the following potential predictors were assessed: clinical and spirometric variables, arterial blood gases, and respiratory muscle strength determined noninvasively. The patients were followed for a period of 3 months. Readmission for exacerbation and time intervals free of hospitalization were recorded.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Univariate analysis showed that the presence of cor pulmonale (<span class="elsevierStyleItalic">P</span> <.05), long-term oxygen therapy (<span class="elsevierStyleItalic">P</span> <.05), hypercapnia (<span class="elsevierStyleItalic">P</span> <.05), and high inspiratory load—mean inspiratory airway pressure measured at the mouth exceeding 0.40 cm H2O and a pressure-time index greater than 0.25 (<span class="elsevierStyleItalic">P</span> <.05 for both variables)— increased the risk of hospitalization for exacerbation. Multivariate analysis showed that only cor pulmonale (<span class="elsevierStyleItalic">P</span> <.05) and a high pressure-time index (>0.25, <span class="elsevierStyleItalic">P</span> <.05) were independently related to risk of readmission.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Cor pulmonale and a high pressure-time index are independent risk factors for hospitalization for exacerbation of moderate-to-severe COPD.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer los factores asociados a la exacerba-ción de la enfermedad pulmonar obstructiva (EPOC) es im-portante para mejorar la supervivencia de los pacientes y conseguir mayor efectividad en su tratamiento. El objetivo de este estudio es identificar las variables asociadas con el reingreso hospitalario en la agudización de la EPOC moderada-grave.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió de forma prospectiva a 90 pacientes con EPOC moderada-grave ingresados de manera consecutiva en nuestro Servicio de Neumología por exacerbación de su enfermedad. En el momento del alta se evaluaron las variables clínicas, espirométricas y gasométri-cas, así como el estado muscular, mediante medidas no in-vasivas. Se realizó un seguimiento de los pacientes durante 3 meses tras el alta. Recogimos las agudizaciones que requi-rieron ingreso hospitalario y el tiempo libre de enfermedad.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El análisis univariado mostró que la coexistencia de <span class="elsevierStyleItalic">cor pulmonale</span> (p < 0,05), el uso de oxigenoterapia domi-ciliaria (p < 0,05), la hipercapnia (p < 0,05) y una elevada car-ga inspiratoria —presión media de la vía respiratoria medida en boca > 0,40 cmH2O e índice presión-tiempo > 0,25 (p < 0,05 para ambas)— aumentan el riesgo de ingreso hospitalario tras una agudización. El análisis multivariado mostró como factores predictivos independientes el <span class="elsevierStyleItalic">cor pulmonale</span> (p < 0,05) y un elevado índice presión-tiempo (mayor de 0,25; p < 0,05).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La coexistencia de <span class="elsevierStyleItalic">cor pulmonale</span> y un elevado índice presión-tiempo son factores predictivos independientes de ingreso hospitalario por agudización en los pacientes con EPOC moderada-grave.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of chronic obstructive pulmonary disease and its exacerbations in general practice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M Miravitlles" 1 => "C Mayordomo" 2 => "M Artés" 3 => "L Sánchez-Agudo" 4 => "F Nicolau" 5 => "JF Segú" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "1999" "volumen" => "93" "paginaInicial" => "173" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10464874" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibiotics are associated with lower relapse rates in outpatients with acute exacerbations of COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "SG Adams" 1 => "J Melo" 2 => "M Luther" 3 => "A Anzueto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2000" "volumen" => "117" "paginaInicial" => "1345" "paginaFinal" => "1352" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10807821" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R Kessler" 1 => "M Faller" 2 => "G Forgaut" 3 => "B Mennecier" 4 => "E Weitzenblum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.159.1.9803117" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "1999" "volumen" => "159" "paginaInicial" => "158" "paginaFinal" => "164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9872834" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors of readmission to hospital for a COPD exacerbation: a prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J García-Aymerich" 1 => "E Farrero" 2 => "MA Félez" 3 => "J Izquierdo" 4 => "RM Marrades" 5 => "JM Antó" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2003" "volumen" => "58" "paginaInicial" => "100" "paginaFinal" => "105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12554887" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "PS Burge" 1 => "PM Calverley" 2 => "PW Jones" 3 => "S Spencer" 4 => "JA Anderson" 5 => "TK Maslen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2000" "volumen" => "320" "paginaInicial" => "1297" "paginaFinal" => "1303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10807619" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multicentre randomised placebo-controlled trial of inhaled fluticasone propionate in patients with chronic obstructive pulmonary disease. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 3 | 4 |
| 2024 October | 34 | 28 | 62 |
| 2024 September | 30 | 21 | 51 |
| 2024 August | 39 | 44 | 83 |
| 2024 July | 26 | 34 | 60 |
| 2024 June | 25 | 25 | 50 |
| 2024 May | 28 | 40 | 68 |
| 2024 April | 19 | 22 | 41 |
| 2024 March | 19 | 17 | 36 |
| 2024 February | 19 | 26 | 45 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 15 | 18 | 33 |
| 2023 January | 15 | 33 | 48 |
| 2022 December | 20 | 28 | 48 |
| 2022 November | 13 | 22 | 35 |
| 2022 October | 22 | 26 | 48 |
| 2022 September | 16 | 17 | 33 |
| 2022 August | 21 | 36 | 57 |
| 2022 July | 19 | 41 | 60 |
| 2022 June | 14 | 33 | 47 |
| 2022 May | 17 | 24 | 41 |
| 2022 April | 19 | 22 | 41 |
| 2022 March | 20 | 42 | 62 |
| 2022 February | 16 | 26 | 42 |
| 2022 January | 20 | 34 | 54 |
| 2021 December | 14 | 29 | 43 |
| 2021 November | 21 | 43 | 64 |
| 2021 October | 22 | 37 | 59 |
| 2021 September | 17 | 41 | 58 |
| 2021 August | 9 | 30 | 39 |
| 2021 July | 12 | 27 | 39 |
| 2021 June | 9 | 36 | 45 |
| 2021 May | 15 | 25 | 40 |
| 2021 April | 21 | 30 | 51 |
| 2021 March | 14 | 23 | 37 |
| 2021 February | 11 | 19 | 30 |
| 2021 January | 6 | 11 | 17 |
| 2020 December | 9 | 12 | 21 |
| 2020 November | 4 | 15 | 19 |
| 2020 October | 8 | 8 | 16 |
| 2020 September | 7 | 9 | 16 |
| 2020 August | 6 | 7 | 13 |
| 2020 July | 16 | 8 | 24 |
| 2020 June | 18 | 5 | 23 |
| 2020 May | 18 | 20 | 38 |
| 2020 April | 14 | 11 | 25 |
| 2020 March | 14 | 14 | 28 |
| 2020 February | 14 | 16 | 30 |
| 2020 January | 22 | 18 | 40 |
| 2019 December | 12 | 16 | 28 |
| 2019 November | 9 | 18 | 27 |
| 2019 October | 5 | 5 | 10 |
| 2019 September | 9 | 12 | 21 |
| 2019 August | 17 | 12 | 29 |
| 2019 July | 11 | 24 | 35 |
| 2019 June | 9 | 15 | 24 |
| 2019 May | 9 | 25 | 34 |
| 2019 April | 52 | 19 | 71 |
| 2019 March | 21 | 16 | 37 |
| 2019 February | 11 | 13 | 24 |
| 2019 January | 7 | 16 | 23 |
| 2018 December | 12 | 17 | 29 |
| 2018 November | 13 | 10 | 23 |
| 2018 October | 19 | 18 | 37 |
| 2018 September | 16 | 18 | 34 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 9 | 5 | 14 |
| 2018 March | 4 | 2 | 6 |
| 2018 February | 5 | 6 | 11 |
| 2018 January | 7 | 9 | 16 |
| 2017 December | 2 | 6 | 8 |
| 2017 November | 3 | 7 | 10 |
| 2017 October | 6 | 12 | 18 |
| 2017 September | 2 | 11 | 13 |
| 2017 August | 6 | 21 | 27 |
| 2017 July | 4 | 17 | 21 |
| 2017 June | 5 | 21 | 26 |
| 2017 May | 4 | 37 | 41 |
| 2017 April | 3 | 8 | 11 |
| 2017 March | 1 | 14 | 15 |
| 2017 February | 1 | 4 | 5 |
| 2017 January | 3 | 4 | 7 |
| 2016 December | 11 | 12 | 23 |
| 2016 November | 13 | 13 | 26 |
| 2016 October | 16 | 16 | 32 |
| 2016 September | 20 | 10 | 30 |
| 2016 August | 5 | 4 | 9 |
| 2016 July | 13 | 0 | 13 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 64 | 1 | 65 |
| 2015 September | 82 | 14 | 96 |
| 2015 August | 60 | 12 | 72 |
| 2015 July | 64 | 7 | 71 |
| 2015 June | 49 | 9 | 58 |
| 2015 May | 61 | 10 | 71 |
| 2015 April | 47 | 9 | 56 |
| 2015 March | 51 | 8 | 59 |
| 2015 February | 59 | 8 | 67 |
| 2015 January | 46 | 4 | 50 |
| 2014 December | 52 | 8 | 60 |
| 2014 November | 47 | 6 | 53 |
| 2014 October | 87 | 8 | 95 |
| 2014 September | 60 | 9 | 69 |
| 2014 August | 53 | 11 | 64 |
| 2014 July | 64 | 6 | 70 |
| 2014 June | 53 | 6 | 59 |
| 2014 May | 61 | 7 | 68 |
| 2014 April | 60 | 4 | 64 |
| 2014 March | 66 | 10 | 76 |
| 2014 February | 65 | 8 | 73 |
| 2014 January | 37 | 10 | 47 |
| 2013 December | 42 | 8 | 50 |
| 2013 November | 44 | 7 | 51 |
| 2013 October | 42 | 13 | 55 |
| 2013 September | 37 | 6 | 43 |
| 2013 August | 54 | 10 | 64 |
| 2013 July | 69 | 17 | 86 |
| 2013 June | 30 | 6 | 36 |
| 2013 May | 35 | 8 | 43 |
| 2013 April | 17 | 5 | 22 |
| 2013 March | 7 | 2 | 9 |
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