2012, Number 2
Applying an Instrument for Stratification of Patients with Decompensated Chronic Obstructive Pulmonary Disease in the Emergency Room
Language: Spanish
References: 12
Page: 9-19
PDF size: 166.39 Kb.
ABSTRACT
Background: Chronic obstructive pulmonary disease is a public health problem of enormous magnitude. This has also been considered at the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos.Objective: To assess the implementation process of a tool for stratification of patients with chronic obstructive pulmonary disease treated in the Emergency Room.
Methods: The instrument was administered to 192 patients admitted and discharged from the institution with a diagnosis of decompensated chronic obstructive pulmonary disease from May 2010 to April 2011. Several indicators of process and outcome were used for the assessment.
Results: The use of the instrument became a medical action quickly and systematically incorporated, although not accompanied by progressive improvement in stratification quality. The prevalence of patients at high risk of adverse outcome and high probability of recovery was determined by a large number of patients with moderate decompensation and association with pneumonia or heart failure, which were mostly stratified as moderate risk and admitted in Internal Medicine rooms. Nevertheless, lethality was relatively low, as well as the frequency of transfers to intensive care units of patients initially admitted to these rooms (10%).
Conclusions: The results obtained in the behavior of lethality and the rate of transfers to intensive care units suggest the convenience of performing modifications to the stratification instrument used.
REFERENCES
11.Corona Martínez LA, Fragoso Marchante MC, González Morales I, Hernández Abreus C, Sierra Martínez D, Fresneda Quintana O. Valoración del índice de riesgo como instrumento para la estratificación del paciente con neumonía adquirida en la comunidad en el Departamento de Urgencias. Medisur[revista en Internet]. 2005[citada 20 May 2011];3(2):[aprox. 5 p.]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/108/4741.
12.Corona Martínez LA, Fragoso Marchante MC, Borroto Lecuna S, Hernández Abreus C, Homes López-Viera B, Domínguez Casillas I. Un instrumento para la estratificación del paciente con neumonía adquirida en la comunidad en el departamento de urgencias. Rev Cubana Med[revista en Internet]. 2006[citado 20 May 2011];45(2):[aprox. 11 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232006000200012.