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Published on: November 8, 2013
Study on factors influencing recrudescent time of postdischarge patients with chronic obstructive pulmonary disease
Lan Wang1, Xiao-Ying Zang, Qing Zhang
1School of Nursing, Tianjin Medical University, Tianjin, China.
Aim:
(1) To explore the prognostic factors of patients with chronic obstructive pulmonary disease. (2) To calculate the recrudescence time (the time from discharge to acute exacerbation again) of postdischarge patients with chronic obstructive pulmonary disease.
Background:
Chronic obstructive pulmonary disease is an airflow limitation illness that is preventable and treatable. To find out the prognostic factors will make effective postdischarge care, which can help patients reduce readmission times and prolong recrudescent time.
Design:
Cohort study.
Method:
From November 2007-October 2008, 136 patients with acute exacerbation of chronic obstructive pulmonary disease were analysed by gender, age, career, education level, body mass index, smoking, oxygen therapy, drug-taken compliance, respiratory function exercise, blood gas, lung function, six-minute walking test and degree of dyspnoea. Factors related to prognosis were analysed by univariate and multivariate Cox regression. Kaplan-Meier method was used for survival analysis and log-rank test for comparison of survival curve.
Results:
A total of 121 patients recrudesced up to October 2009. Recrudescence rate was 7·35% in a month, 25·00% in three months, 55·62% in six months and 88·23% in 12 months. Higher drug-taken compliance and respiratory function exercise were the factors influencing patients' acute exacerbation (p < 0·05). The median recrudescence time of drug taken or not was six and four months, and doing respiratory function exercise or not was eight and six months.
Conclusion:
Respiratory function exercise and higher drug-taken compliance can prolong recrudescence time and reduce recrudescence rate.
Relevance To Clinical Practice:
Clinical nurses who know more risk factors about acute exacerbation of patients with chronic obstructive pulmonary disease can provide effective discharge planning, which will increase patients' quality of life and decrease mortality.
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