Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study
Abstract Background Exacerbation is an independent risk factor for chronic obstructive pulmonary disease (COPD)-related morbidity and mortality. Despite optimal care, there may be risk factors that lead to difficulties in managing exacerbations that may be associated with prolongation of length of h...
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BMC
2024-11-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-024-03399-7 |
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| author | Dorina Esendağlı Nurdan Köktürk Ayşe Baha Dilek Yapar Seçil Özkan Elif Şen Fatma Çiftçi Burcu Öztürk Sümeyye Kodalak Cengiz Gaye Ulubay İrem Şerifoğlu Yelda Varol Aydan Mertoğlu Ali Kadri Çırak Onur Turan Neşe Dursunoğlu Nilüfer Savurmuş Alev Gürgün Funda Elmas Lütfi Çöplü Ümran Sertçelik Reyhan Yıldız İpek Özmen Aylin Alpaydın Mehmet Polatlı Ebru Karaçay Yeşiloğlu Deniz Çelik |
| author_facet | Dorina Esendağlı Nurdan Köktürk Ayşe Baha Dilek Yapar Seçil Özkan Elif Şen Fatma Çiftçi Burcu Öztürk Sümeyye Kodalak Cengiz Gaye Ulubay İrem Şerifoğlu Yelda Varol Aydan Mertoğlu Ali Kadri Çırak Onur Turan Neşe Dursunoğlu Nilüfer Savurmuş Alev Gürgün Funda Elmas Lütfi Çöplü Ümran Sertçelik Reyhan Yıldız İpek Özmen Aylin Alpaydın Mehmet Polatlı Ebru Karaçay Yeşiloğlu Deniz Çelik |
| author_sort | Dorina Esendağlı |
| collection | DOAJ |
| description | Abstract Background Exacerbation is an independent risk factor for chronic obstructive pulmonary disease (COPD)-related morbidity and mortality. Despite optimal care, there may be risk factors that lead to difficulties in managing exacerbations that may be associated with prolongation of length of hospital stay (LOS). Methods This is a multicenter prospective observational study of COPD patients hospitalized with exacerbations. Prolonged LOS was calculated according to the 50th percentile and defined as ≥ 9 days. Potentially predicting factors of LOS were stratified into 4 pillars as patient-related, disease and exacerbation-related, treatment-related and, hospital utility-related. These categories were systematically documented throughout the duration of the hospitalization. Results A total of 434 patients, 361 males and 73 females, with a mean age of 69.2 ± 9.3 years, were included in the study. Variables of each pillar were tested with univariate analysis to identify potential risk factors for prolonged LOS. Subsequently significant factors excluding factors associated with hospital utility were tested with multivariate logistic regression analysis for detecting potential associated factors for difficult-to-manage COPD exacerbation. Biomass exposure, past history of non-invasive mechanical ventilation (NIMV), low bicarbonate levels at admission, antibiotic switching, need for theophylline, increasing oxygen requirement, need for in-hospital non-invasive mechanical ventilation, nutritional support and physiotherapy were found as defining factors. Conclusions The DiMECO study can help to identify COPD exacerbators who are at risk for prolonged hospitalizations that may associate with difficult-to-manage COPD exacerbations. Difficult to manage COPD exacerbation may serve as a provocative framework, underscoring the necessity for a better understanding of the multifaceted approaches to the management of COPD exacerbations. This conceptualization warrants further investigation across diverse clinical settings to validate its applicability and efficacy. |
| format | Article |
| id | doaj-art-8068eea4591e43688cb70caec87ea64a |
| institution | OA Journals |
| issn | 1471-2466 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-8068eea4591e43688cb70caec87ea64a2025-08-20T02:08:18ZengBMCBMC Pulmonary Medicine1471-24662024-11-0124111110.1186/s12890-024-03399-7Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO StudyDorina Esendağlı0Nurdan Köktürk1Ayşe Baha2Dilek Yapar3Seçil Özkan4Elif Şen5Fatma Çiftçi6Burcu Öztürk7Sümeyye Kodalak Cengiz8Gaye Ulubay9İrem Şerifoğlu10Yelda Varol11Aydan Mertoğlu12Ali Kadri Çırak13Onur Turan14Neşe Dursunoğlu15Nilüfer Savurmuş16Alev Gürgün17Funda Elmas18Lütfi Çöplü19Ümran Sertçelik20Reyhan Yıldız21İpek Özmen22Aylin Alpaydın23Mehmet Polatlı24Ebru Karaçay Yeşiloğlu25Deniz Çelik26Chest Diseases Department, Başkent University School of MedicineDepartment of Pulmonary Medicine, Gazi University School of MedicineChest Diseases Department, Near East University Faculty of MedicineDepartment of Biostatistics and Medical Informatics, Akdeniz University Faculty of MedicinePublic Health Department, Gazi University School of MedicineChest Diseases Department, School of Medicine, Ankara UniversityChest Diseases Department, School of Medicine, Ankara UniversityChest Diseases Department, 25 Aralık State HospitalDepartment of Chest Diseases, Kartal Lütfi Kırdar Traning and Research HospitalChest Diseases Department, Başkent University School of MedicineChest Diseases Department, Ankara City Hospital, Ministry of Health UniversityChest Diseases Department, Dr. Suat Seren Chest Diseases and Chest Surgery Traning and Research Hospital, İzmir Health Sciences UniversityChest Diseases Department, Dr. Suat Seren Chest Diseases and Chest Surgery Traning and Research Hospital, İzmir Health Sciences UniversityChest Diseases Department, Dr. Suat Seren Chest Diseases and Chest Surgery Traning and Research Hospital, İzmir Health Sciences UniversityChest Diseases Department, İzmir Katip Çelebi University Faculty of MedicineChest Diseases Department, Pamukkale University Faculty of MedicineChest Diseases Department, Pamukkale University Faculty of MedicineChest Diseases Department, Ege University Faculty of MedicineChest Diseases Department, Ege University Faculty of MedicineChest Diseases Department, Hacettepe University Faculty of MedicineChest Diseases Department, Ankara City Hospital, Ministry of Health UniversityChest Diseases Department, Süreyyapaşa Chest Diseases and Chest Surgery Traning and Research HospitalChest Diseases Department, Süreyyapaşa Chest Diseases and Chest Surgery Traning and Research HospitalChest Diseases Department, Dokuz Eylül University Faculty of MedicineChest Diseases Department, Aydin Adnan Menderes UniversityAtaturk Chest Disease and Chest Surgery Education and Research Hospital, Department of PulmonologyAtaturk Chest Disease and Chest Surgery Education and Research Hospital, Department of PulmonologyAbstract Background Exacerbation is an independent risk factor for chronic obstructive pulmonary disease (COPD)-related morbidity and mortality. Despite optimal care, there may be risk factors that lead to difficulties in managing exacerbations that may be associated with prolongation of length of hospital stay (LOS). Methods This is a multicenter prospective observational study of COPD patients hospitalized with exacerbations. Prolonged LOS was calculated according to the 50th percentile and defined as ≥ 9 days. Potentially predicting factors of LOS were stratified into 4 pillars as patient-related, disease and exacerbation-related, treatment-related and, hospital utility-related. These categories were systematically documented throughout the duration of the hospitalization. Results A total of 434 patients, 361 males and 73 females, with a mean age of 69.2 ± 9.3 years, were included in the study. Variables of each pillar were tested with univariate analysis to identify potential risk factors for prolonged LOS. Subsequently significant factors excluding factors associated with hospital utility were tested with multivariate logistic regression analysis for detecting potential associated factors for difficult-to-manage COPD exacerbation. Biomass exposure, past history of non-invasive mechanical ventilation (NIMV), low bicarbonate levels at admission, antibiotic switching, need for theophylline, increasing oxygen requirement, need for in-hospital non-invasive mechanical ventilation, nutritional support and physiotherapy were found as defining factors. Conclusions The DiMECO study can help to identify COPD exacerbators who are at risk for prolonged hospitalizations that may associate with difficult-to-manage COPD exacerbations. Difficult to manage COPD exacerbation may serve as a provocative framework, underscoring the necessity for a better understanding of the multifaceted approaches to the management of COPD exacerbations. This conceptualization warrants further investigation across diverse clinical settings to validate its applicability and efficacy.https://doi.org/10.1186/s12890-024-03399-7COPDExacerbationProlonged hospitalizationDifficult to manage COPD exacerbation |
| spellingShingle | Dorina Esendağlı Nurdan Köktürk Ayşe Baha Dilek Yapar Seçil Özkan Elif Şen Fatma Çiftçi Burcu Öztürk Sümeyye Kodalak Cengiz Gaye Ulubay İrem Şerifoğlu Yelda Varol Aydan Mertoğlu Ali Kadri Çırak Onur Turan Neşe Dursunoğlu Nilüfer Savurmuş Alev Gürgün Funda Elmas Lütfi Çöplü Ümran Sertçelik Reyhan Yıldız İpek Özmen Aylin Alpaydın Mehmet Polatlı Ebru Karaçay Yeşiloğlu Deniz Çelik Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study BMC Pulmonary Medicine COPD Exacerbation Prolonged hospitalization Difficult to manage COPD exacerbation |
| title | Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study |
| title_full | Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study |
| title_fullStr | Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study |
| title_full_unstemmed | Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study |
| title_short | Risk factors for prolonged hospitalization as a marker for difficult-to-manage exacerbations of chronic obstructive lung disease (COPD): the DiMECO Study |
| title_sort | risk factors for prolonged hospitalization as a marker for difficult to manage exacerbations of chronic obstructive lung disease copd the dimeco study |
| topic | COPD Exacerbation Prolonged hospitalization Difficult to manage COPD exacerbation |
| url | https://doi.org/10.1186/s12890-024-03399-7 |
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