Five-year experience in providing medical care to patients with bronchopulmonary pathology with chronic hypoxemic respiratory failure
- Autores: Titova O.N.1, Kuzubova N.A.1, Volchkov V.A.2, Kozyrev A.G.1, Skljarova D.B.1
-
Afiliações:
- I.P. Pavlov First Saint Petersburg State Medical University
- Saint Petersburg State University
- Edição: Volume 64, Nº 3 (2020)
- Páginas: 117-123
- Seção: HEALTH CARE ORGANIZATION
- ##submission.dateSubmitted##: 25.10.2024
- URL: https://archivog.com/0044-197X/article/view/637656
- DOI: https://doi.org/10.46563/0044-197X-2020-64-3-117-123
- ID: 637656
Citar
Texto integral
Resumo
Introduction. The article considers the management of medical care for patients with chronic hypoxemic respiratory failure (CHRF), including long-term oxygen therapy (LOT). To achieve this goal in 2013 there was established the St. Petersburg Municipal Pulmonary Center (MPC).
The study aimed to assess the results of the MPC activity in 2014 - 2LC138727590CN018.
Material and methods. The medical records of patients admitted to the MPC in 2014-2018 were studied. To process the information conventional statistical methods were used.
Results. Over the past 5 years, MRC specialists have consulted 13,239 patients, mainly COPD cases. 1,054 patients with CHRF were hospitalized for an additional examination, and 435 cases were indicated to receive LOT. The necessary oxygen concentrator facilities were provided at the expense of the St. Petersburg city budget. Mortality rate accounted for 10.4% by the end of the first year of LOT, 15.1% by the end of the second year, reaching 27.0% and 38.3% by the end of the third and fourth years, respectively. In the group of COPD patients with CHRF (262 patients, 238 men, and 24 women, at the average age of 69 ± 3 years), LOT was accompanied by a decrease in the number of severe exacerbations of the disease (before the LOT - 3 (3; 4) severe exacerbations per year, after a year - 2 (1; 2); p <0.001), as well as cases of referral and duration of stay in the intensive care unit. This led to a decrease in the average cost of inpatient treatment from 264,912 ± 31,277 rubles per year to 134,826 ± 21,277; p <0.001.
Conclusion. Early verification and correction of CHRF contribute not only to the decline in the number of exacerbations of respiratory disease but also to the reduction of financial costs necessary for the treatment of such patients.
Palavras-chave
Sobre autores
Olga Titova
I.P. Pavlov First Saint Petersburg State Medical University
Autor responsável pela correspondência
Email: noemail@neicon.ru
ORCID ID: 0000-0003-4678-3904
Rússia
Natalia Kuzubova
I.P. Pavlov First Saint Petersburg State Medical University
Email: noemail@neicon.ru
ORCID ID: 0000-0002-1166-9717
Rússia
Vladimir Volchkov
Saint Petersburg State University
Email: noemail@neicon.ru
ORCID ID: 0000-0002-5664-7386
Rússia
Andrey Kozyrev
I.P. Pavlov First Saint Petersburg State Medical University
Email: kozyrev@bk.ru
ORCID ID: 0000-0002-9270-3779
Rússia
Darya Skljarova
I.P. Pavlov First Saint Petersburg State Medical University
Email: noemail@neicon.ru
ORCID ID: 0000-0001-7052-6903
Rússia
Bibliografia
- Chuchalin A.G., ed.Respiratory Medicine. Volume 3[Respiratornaya meditsina. Tom 3]. Moscow: Littera; 2017: 356-438. (in Russian)
- Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann. Intern. Med. 1980; 93(3): 391-8. https://doi.org/10.7326/0003-4819-93-3-391
- Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Report of the Medical Research Council Working Party. Lancet. 1981; 1(8222): 681-6.
- Ekström M., Ahmadi Z., Larsson H., Nilsson T., Wahlberg J., Ström K.E., et al. A nationwide structure for valid long-term oxygen therapy: 29-year prospective data in Sweden. Int. J. Chron. Obstruct. Pulmon. Dis. 2017; 12: 3159-69. https://doi.org/10.2147/COPD.S140264
- Ringbaek T.J., Lange P. Trends in long-term oxygen therapy for COPD in Denmark from 2001 to 2010. Respir. Med. 2014; 108(3): 511-6. https://doi.org/10.1016/j.rmed.2013.10.025
- Fuhrman C., Boussac-Zarebska M., Roche N., Delmas M.C. Longterm oxygen therapy in France, 2006-2011. Rev. Mal. Respir. 2014; 31(5): 421-9. https://doi.org/10.1016/j.rmr.2013.06.007
- Kida K., Motegi T., Ishii T., Hattori K. Long-term oxygen therapy in Japan: history, present status, and current problems. Pneumonol. Alergol. Pol. 2013; 81(5): 468-78.
- Klement R.F., Lavrushin A.A., Ter-Pogosyan P.A., Kategov Yu.M. Instructions for the Use of Formulas and Tables of Proper Values of the Main Spirographic Indicators [Instruktsiya po primeneniyu formul i tablits dolzhnykh velichin osnovnykh spirograficheskikh pokazateley]. Leningrad; 1986. (in Russian)
- Titova O.N., Kuzubova N.A., Sklyarova D.B., Volchkov V.A., Gichkin A.Yu. Predictors of progression of chronic respiratory insufficiency in patients with chronic obstructive pulmonary disease. Vestnik Rossiyskoy voenno-meditsinskoy akademii. 2016; (4): 82-6. (in Russian)
- Titova O.N., Kuzubova N.A., Volchkov V.A., Kozyrev A.G., Gichkin A.Yu., Sklyarova D.B. Functional state of the diaphragm in patients with chronic obstructive pulmonary disease on long-term oxygen therapy. Byulleten’ sibirskoy meditsiny. 2016; 15(5): 126-33. https://doi.org/10.20538/1682-0363-2016-5-126-133 (in Russian)
- Titova O.N., Kuzubova N.A., Sklyarova D.B., Volchkov V.A., Gichkin A.Yu., Volchkova E.V. The influence of long-term oxygen treatment on systemic inflammation, the function of the diaphragm and hemodynamics in patients with chronic obstructive pulmonary disease. Meditsinskiy al’yans. 2017; (4): 80-7. (in Russian)
- Gulbas G., Gunen H., In E., Kilic T. Long-term follow-up of chronic obstructive pulmonary disease patients on long-term oxygen treatment. Int. J. Clin. Pract. 2012; 66(2): 152-7. https://doi.org/10.1111/j.1742-1241.2011.02833.x
- Pavlov N., Haynes A.G., Stucki A., Jüni P., Ott S.R. Long-term oxygen therapy in COPD patients: population-based cohort study on mortality. Int. J. Chron. Obstruct. Pulmon. Dis. 2018; 13: 979-88. https://doi.org/10.2147/COPD.S154749
- Ringbaek T.J., Viskum K., Lange P. Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease? Eur. Respir. J. 2002; 20(1): 38-42. https://doi.org/10.1183/09031936.02.00284202
- Cho K.H., Kim Y.S., Nam C.M., Kim T.H., Kim S.J., Han K.T., et al. Home oxygen therapy reduces risk of hospitalisation in patients with chronic obstructive pulmonary disease: a population-based retrospective cohort study, 2005-2012. BMJ Open. 2015; 5(11): e009065. https://doi.org/10.1136/bmjopen-2015-009065
- Garcia-Aymerich J., Monsó E., Marrades R.M., Escarrabill J., Félez M.A., Sunyer J., et al. Risk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation. EFRAM study. Am. J. Respir. Crit. Care Med. 2001; 164(6): 1002-7. https://doi.org/10.1164/ajrccm.164.6.2006012
- Chiang C.H. Cost analysis of chronic obstructive pulmonary disease in a tertiary care setting in Taiwan. Respirology. 2008; 13(5): 689-94. https://doi.org/10.1111/j.1440-1843.2008.01308.x
- Wallace A.E., Kaila S., Bayer V., Shaikh A., Shinde M.U., Willey V.J., et al. Health Care Resource Utilization and Exacerbation Rates in Patients with COPD Stratified by Disease Severity in a Commercially Insured Population. J. Manag. Care Spec. Pharm. 2019; 25(2): 205-17. https://doi.org/10.18553/jmcp.2019.25.2.205
- Pasquale M.K., Sun S.X., Song F., Hartnett H.J., Stemkowski S.A. Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population. Int. J. Chron. Obstruct. Pulmon. Dis. 2012; 7: 757-64. https://doi.org/10.2147/COPD.S36997
- Takir H.B., Karakurt Z., Salturk C., Kargin F., Balci M., Yalcinsoy M., et al. Reasons for ICU demand and long-term follow-up of a chronic obstructive pulmonary disease cohort. COPD. 2014; 11(6): 627-38. https://doi.org/10.3109/15412555.2014.898041
- Dalal A.A., Shah M., D’Souza A.O., Rane P. Costs of COPD exacerbations in the emergency department and inpatient setting. Respir. Med. 2011; 105(3): 454-60. https://doi.org/10.1016/j.rmed.2010.09.003
Arquivos suplementares
