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...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2012-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0042156 |
| _version_ | 1828954514847170560 |
|---|---|
| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-14T07:31:06Z |
| format | Article |
| id | doaj.art-1b9ababda60840468500bfecbcc754ac |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T07:31:06Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1b9ababda60840468500bfecbcc754ac2022-12-21T23:11:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0177e4215610.1371/journal.pone.0042156Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.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 Group<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.https://doi.org/10.1371/journal.pone.0042156 |
| spellingShingle | 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. PLoS ONE |
| title | 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_short | 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 |
| url | https://doi.org/10.1371/journal.pone.0042156 |
| work_keys_str_mv | AT franciscopozorodriguez clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT joseluislopezcampos clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT carlosjalvarezmartinez clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT adycastroacosta clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT ramonaguero clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT javierhueto clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT jesushernandezhernandez clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT manuelbarron clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT victorabraira clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT anabelforte clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT juanmiguelsancheznieto clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT encarnacionlopezgabaldon clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT borjagcosio clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT alvaragusti clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy AT audipocstudygroup clinicalauditofcopdpatientsrequiringhospitaladmissionsinspainaudipocstudy |