Get with the guidelines : management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub-optimal

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http://hdl.handle.net/10138/313990

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the AANZDEM and EuroDEM study groups , Kelly , A-M , Van Meer , O & Laribi , S 2020 , ' Get with the guidelines : management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub-optimal ' , Internal Medicine Journal , vol. 50 , no. 2 , pp. 200-208 . https://doi.org/10.1111/imj.14323

Title: Get with the guidelines : management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub-optimal
Author: the AANZDEM and EuroDEM study groups; Kelly, Anne-Maree; Van Meer, Oene; Laribi, Said
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Date: 2020-02
Language: eng
Number of pages: 9
Belongs to series: Internal Medicine Journal
ISSN: 1444-0903
DOI: https://doi.org/10.1111/imj.14323
URI: http://hdl.handle.net/10138/313990
Abstract: Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are common in emergency departments (ED). Guidelines recommend administration of inhaled bronchodilators, systemic corticosteroids and antibiotics along with non-invasive ventilation (NIV) for patients with respiratory acidosis. Aim: To determine compliance with guideline recommendations for patients treated for COPD in ED in Europe (EUR) and South East Asia/Australasia (SEA) and to compare management and outcomes. Methods: In each region, an observational prospective cohort study was performed that included patients presenting to ED with the main complaint of dyspnoea during three 72-h periods. This planned sub-study included those with an ED primary discharge diagnosis of COPD. Data were collected on demographics, clinical features, treatment, disposition and in-hospital mortality. We determined overall compliance with guideline recommendations and compared treatments and outcome between regions. Results: A total of 801 patients was included from 122 ED (66 EUR and 46 SEA). Inhaled bronchodilators were administered to 80.3% of patients, systemic corticosteroids to 59.5%, antibiotics to 44 and 60.6% of patients with pH Conclusion: Compliance with guideline recommended treatments, in particular administration of corticosteroids and NIV, was sub-optimal in both regions. Improved compliance has the potential to improve patient outcome.
Subject: 3121 General medicine, internal medicine and other clinical medicine
Dyspnoea
emergency department
management
COPD
outcome
ASIA
NEW-ZEALAND DYSPNEA
ACUTE EXACERBATIONS
PREDICTORS
dyspnoea
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