Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

<h4>Backgrounds</h4>AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters wi...

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Autores principales: Francisco Pozo-Rodríguez, Jose Luis López-Campos, Carlos J Alvarez-Martínez, Ady Castro-Acosta, Ramón Agüero, Javier Hueto, Jesús Hernández-Hernández, Manuel Barrón, Victor Abraira, Anabel Forte, Juan Miguel Sanchez Nieto, Encarnación Lopez-Gabaldón, Borja G Cosío, Alvar Agustí, AUDIPOC Study Group
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Publicado: Public Library of Science (PLoS) 2012
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spelling oai:doaj.org-article:1b9ababda60840468500bfecbcc754ac2021-11-18T07:10:11ZClinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.1932-620310.1371/journal.pone.0042156https://doaj.org/article/1b9ababda60840468500bfecbcc754ac2012-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0042156https://doaj.org/toc/1932-6203<h4>Backgrounds</h4>AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines.<h4>Methodology/principal findings</h4>An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles.<h4>Conclusions/significance</h4>The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.Francisco Pozo-RodríguezJose Luis López-CamposCarlos J Alvarez-MartínezAdy Castro-AcostaRamón AgüeroJavier HuetoJesús Hernández-HernándezManuel BarrónVictor AbrairaAnabel ForteJuan Miguel Sanchez NietoEncarnación Lopez-GabaldónBorja G CosíoAlvar AgustíAUDIPOC Study GroupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e42156 (2012)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Francisco Pozo-Rodríguez
Jose Luis López-Campos
Carlos J Alvarez-Martínez
Ady Castro-Acosta
Ramón Agüero
Javier Hueto
Jesús Hernández-Hernández
Manuel Barrón
Victor Abraira
Anabel Forte
Juan Miguel Sanchez Nieto
Encarnación Lopez-Gabaldón
Borja G Cosío
Alvar Agustí
AUDIPOC Study Group
Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
description <h4>Backgrounds</h4>AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines.<h4>Methodology/principal findings</h4>An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles.<h4>Conclusions/significance</h4>The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.
format article
author Francisco Pozo-Rodríguez
Jose Luis López-Campos
Carlos J Alvarez-Martínez
Ady Castro-Acosta
Ramón Agüero
Javier Hueto
Jesús Hernández-Hernández
Manuel Barrón
Victor Abraira
Anabel Forte
Juan Miguel Sanchez Nieto
Encarnación Lopez-Gabaldón
Borja G Cosío
Alvar Agustí
AUDIPOC Study Group
author_facet Francisco Pozo-Rodríguez
Jose Luis López-Campos
Carlos J Alvarez-Martínez
Ady Castro-Acosta
Ramón Agüero
Javier Hueto
Jesús Hernández-Hernández
Manuel Barrón
Victor Abraira
Anabel Forte
Juan Miguel Sanchez Nieto
Encarnación Lopez-Gabaldón
Borja G Cosío
Alvar Agustí
AUDIPOC Study Group
author_sort Francisco Pozo-Rodríguez
title Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
title_short Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
title_full Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
title_fullStr Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
title_full_unstemmed Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.
title_sort clinical audit of copd patients requiring hospital admissions in spain: audipoc study.
publisher Public Library of Science (PLoS)
publishDate 2012
url https://doaj.org/article/1b9ababda60840468500bfecbcc754ac
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