Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation Full Text
BMC Pulmonary Medicine, 06/29/2012
Ban A et al. – The implementation of clinical pathway –reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease.Methods
- The authors developed a CP and evaluated its effectiveness in a non–randomized prospective study with historical controls on patients admitted for exacerbation of COPD to UniversitiKebangsaan Malaysia Medical Centre (UKMMC).
- Consecutive patients who were admitted between June 2009 and December 2010 were prospectively recruited into the CP group.
- Non–CP historical controls were obtained from case records of patients admitted between January 2008 and January 2009.
- Clinical outcomes were evaluated by comparing the length of stay (LOS), complication rates, readmissions, and mortality rates.
- Ninety–five patients were recruited in the CP group and 98 patients were included in the non–CP historical group.
- Both groups were comparable with no significant differences in age, sex and severity of COPD (p = 0.641).
- For clinical outcome measures, patients in the CP group had shorter length of stay than the non–CP group (median (IQR): 5 (4–7) days versus 7 (7–9) days, p < 0.001) and 24.1% less complications (14.7% versus 38.8%, p < 0.001). The authors did not find any significant differences in readmission and mortality rates.