Birgit Refsgaard Iversen, Lotte Ørneborg Rodkjær, Vibeke Bregnballe, Anders Løkke
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引用次数: 2
摘要
背景:慢性阻塞性肺疾病(COPD)的恶化随着疾病严重程度的提高而变得更加频繁,患者往往最终住院。目的:评价建立跨部门肺治疗小组(cross-sector lung team, CLT)对COPD高危加重患者病情加重的影响。方法:49例重度COPD患者接受CLT治疗6个月。根据参与者的要求,CLT可以日夜打电话和家访,开始治疗并提供建议。在干预年份前3年收集住院数据,以预测未来入院人数和住院时间。这些预测与观测数据进行了比较。干预前后分别进行COPD评估试验(CAT)。结果:观察到住院风险(0.54 (95% CI 0.32;0.90), p = 0.0192))和慢性阻塞性肺病住院时间(0.41 (95% CI 0.22;0.76), p = 0.0046)),显著低于预期。观察到总CAT评分1.10 (95%CI: -0.71;2.91), p = 0.226)的数值上但无显著改善。结论:在高危人群中,加入CLT似乎可以降低COPD恶化的负担。
The impact on severe exacerbations of establishing a cross-sectorial lung team for patients with COPD at high risk of exacerbating: a pilot study.
Background: Exacerbation in Chronic obstructive pulmonary disease (COPD) becomes more frequent with advancing disease severity and often the patients end up being hospitalized. Objective: To evaluate the impact on exacerbations of establishing a cross-sectorial lung team (CLT) for patients with COPD at high risk of exacerbating. Methods: In total, 49 patients with severe COPD were affiliated to a CLT for 6 months. On request from the participants, the CLT was available for telephone calls and home visits day and night to initiate treatment and give advice. Data regarding hospitalizations were collected 3 years prior to the intervention year to predict future numbers of admissions and length of stay. These predictions were compared with the observed data. COPD assessment test (CAT) was conducted before and after intervention. Results: Observed risk of hospitalization (0.54 (95% CI 0.32; 0.90), p = 0.0192)) and length of hospital stay due to COPD (0.41 (95% CI 0.22; 0.76), p = 0.0046)) were significantly lower during the intervention period than predicted. A numerical but non-significant improvement in the total CAT score of 1.10 (95%CI: -0.71;2.91), p = 0.226)) was observed. Conclusion: Affiliation to a CLT seemed to lower the burden of COPD exacerbations in a high-risk population.