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

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 guideli...

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Bibliographic Details
Published in:PloS one 2012-07, Vol.7 (7), p.e42156-e42156
Main Authors: Pozo-Rodríguez, Francisco, López-Campos, Jose Luis, Alvarez-Martínez, Carlos J, Castro-Acosta, Ady, Agüero, Ramón, Hueto, Javier, Hernández-Hernández, Jesús, Barrón, Manuel, Abraira, Victor, Forte, Anabel, Sanchez Nieto, Juan Miguel, Lopez-Gabaldón, Encarnación, Cosío, Borja G, Agustí, Alvar
Format: Article
Language:English
Subjects:
Auditing
Auditoria
Audits
Bayes Theorem
Biomedical research
Chronic obstructive lung disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary diseases
Clinical Audit - standards
Clinical Audit - statistics & numerical data
Clinical medicine
Espanya
Evidence-based medicine
Guideline Adherence - standards
Guideline Adherence - statistics & numerical data
Guidelines
Health care
Hospital admission and discharge
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Hospitals - standards
Hospitals - statistics & numerical data
Humans
Lung diseases
Malalties pulmonars obstructives cròniques
Medical research
Medicine
Mortality
Multivariate Analysis
Obstructive lung disease
Patients
Population
Practice Guidelines as Topic - standards
Pulmonary Disease, Chronic Obstructive - epidemiology
Quality
Recruitment
Regression Analysis
Respiratory diseases
Spain
Spain - epidemiology
Variability
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Description
Summary: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. 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 (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0042156