Relevant bibliographies by topics / Exacerbationer

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Exacerbationer'

Author: Grafiati
Published: 12 August 2021
Last updated: 1 February 2022

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Journal articles on the topic "Exacerbationer"

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Dang-Tan, Tam, Shiyuan Zhang, Ruben V. Tavares, Melissa Stutz, Afisi S. Ismaila, Julie Vaillancourt, Diane Corriveau, et al. "The Burden of Illness Related to Chronic Obstructive Pulmonary Disease Exacerbations in Québec, Canada." Canadian Respiratory Journal 2017 (2017): 1–10. http://dx.doi.org/10.1155/2017/8184915.

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Background. Chronic obstructive pulmonary disease (COPD) prevalence in Canada has risen over time. COPD-related exacerbations contribute to the increased health care utilization (HCU) in this population. This study investigated the impact of exacerbations on COPD-related HCU. Methods. This retrospective observational cohort study used patient data from the Québec provincial health insurance databases. Eligible patients with a new HCU claim with a diagnostic billing for COPD during 2001–2010 were followed until March 31, 2011. Exacerbation rates and time to first exacerbation were assessed. Unadjusted analyses and multivariable models compared the rate of HCU by exacerbation classification (any [moderate/severe], moderate, or severe). Results. The exacerbation event rate in patients with an exacerbation was 34.3 events/100 patient-years (22.7 for moderate exacerbations and 11.6 for severe exacerbations). Median time to first exacerbation of any classification was 37 months. In unadjusted analyses, COPD-related HCU significantly increased with exacerbation severity. In the multivariable, HCU rates were significantly higher after exacerbation versus before exacerbation (p<0.01) for patients with an exacerbation or moderate exacerbations. For severe exacerbations, general practitioner, respiratory specialist, emergency room, and hospital visits were significantly higher after exacerbation versus before exacerbation (p<0.001). Conclusions. Exacerbations were associated with increased HCU, which was more pronounced for patients with severe exacerbations. Interventions to reduce the risk of exacerbations in patients with COPD may reduce disease burden.
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Krachunov, Iliya, Nikolay Kyuchukov, Zlatina Ivanova, Nikolay A. Yanev, Petkana A. Hristova, Plamen Pavlov, Pavlina Glogovska, Tsanya Popova, and Yavor Y. Ivanov. "Stability of Frequent Exacerbator Phenotype in Patients with Chronic Obstructive Pulmonary Disease." Folia Medica 60, no. 4 (December 1, 2018): 536–45. http://dx.doi.org/10.2478/folmed-2018-0023.

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Abstract Background: At present, there is little information in Bulgaria regarding the rate and stability of frequent-exacerbation phenotype in COPD patients. Aim: To study the rate and stability of frequent-exacerbation phenotype in COPD patients. Materials and methods: We followed up 465 COPD patients for exacerbations over a 3-year period. Exacerbations were defined as events that resulted in treatment with antibiotics and/or corticosteroids (moderate), or that led to hospitalization (severe). Result: Approximately 10% of the patients had two or more exacerbations per year (frequent-exacerbation phenotype), and this structure stayed stable over the study period. The exacerbation rate in the first year of follow up was 0.33 per stage I COPD patients (according to GOLD stages), 0.49 per stage II COPD patients; 0.69 - for stage III, and 1.06 for stage IV COPD patients. The frequent-exacerbation rate increased from stage I to stage IV by 4.35%, 9.17%, 10.79%, and 20.97%, respectively. A history of previous year exacerbations increased the risk of new exacerbations: with a history of one exacerbation - OR 2.1820 (95% CI: 1.4018 to 3.3965, p = 0.0005), and with a history of two exacerbations - OR 4.6460 (95% CI: 2.3286 to 9.2696; p < 0.0001). The frequent-exacerbation phenotype appeared to be unstable over the study period - up to 33% from those patients stayed in the phenotype for the next year. Conclusions: The exacerbation frequency and the rate of frequent-exacerbation phenotype increases with COPD progression. History of exacerbations in the previous year is a significant risk factor for exacerbations of COPD. The frequent-exacerbation phenotype appeared to be unstable over the study period. The pheno-type of non-exacerbators was more likely to remain stable over time.
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Mayhew, David, Nathalie Devos, Christophe Lambert, James R. Brown, Stuart C. Clarke, Viktoriya L. Kim, Michal Magid-Slav, et al. "Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations." Thorax 73, no. 5 (January 31, 2018): 422–30. http://dx.doi.org/10.1136/thoraxjnl-2017-210408.

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BackgroundAlterations in the composition of the lung microbiome associated with adverse clinical outcomes, known as dysbiosis, have been implicated with disease severity and exacerbations in COPD.ObjectiveTo characterise longitudinal changes in the lung microbiome in the AERIS study (Acute Exacerbation and Respiratory InfectionS in COPD) and their relationship with associated COPD outcomes.MethodsWe surveyed 584 sputum samples from 101 patients with COPD to analyse the lung microbiome at both stable and exacerbation time points over 1 year using high-throughput sequencing of the 16S ribosomal RNA gene. We incorporated additional lung microbiology, blood markers and in-depth clinical assessments to classify COPD phenotypes.ResultsThe stability of the lung microbiome over time was more likely to be decreased in exacerbations and within individuals with higher exacerbation frequencies. Analysis of exacerbation phenotypes using a Markov chain model revealed that bacterial and eosinophilic exacerbations were more likely to be repeated in subsequent exacerbations within a subject, whereas viral exacerbations were not more likely to be repeated. We also confirmed the association of bacterial genera, including Haemophilus and Moraxella, with disease severity, exacerbation events and bronchiectasis.ConclusionsSubtypes of COPD have distinct bacterial compositions and stabilities over time. Some exacerbation subtypes have non-random probabilities of repeating those subtypes in the future. This study provides insights pertaining to the identification of bacterial targets in the lung and biomarkers to classify COPD subtypes and to determine appropriate treatments for the patient.Trial registration numberResults, NCT01360398.
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Sadatsafavi, Mohsen, Don D. Sin, Zafar Zafari, Gerard Criner, John E. Connett, Stephen Lazarus, Meilan Han, Fernando Martinez, and Richard Albert. "The Association Between Rate and Severity of Exacerbations in Chronic Obstructive Pulmonary Disease: An Application of a Joint Frailty-Logistic Model." American Journal of Epidemiology 184, no. 9 (November 1, 2016): 681–89. http://dx.doi.org/10.1093/aje/kww085.

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Abstract Exacerbations are a hallmark of chronic obstructive pulmonary disease (COPD). Evidence suggests the presence of substantial between-individual variability (heterogeneity) in exacerbation rates. The question of whether individuals vary in their tendency towards experiencing severe (versus mild) exacerbations, or whether there is an association between exacerbation rate and severity, has not yet been studied. We used data from the MACRO Study, a 1-year randomized trial of the use of azithromycin for prevention of COPD exacerbations (United States and Canada, 2006–2010; n = 1,107, mean age = 65.2 years, 59.1% male). A parametric frailty model was combined with a logistic regression model, with bivariate random effects capturing heterogeneity in rate and severity. The average rate of exacerbation was 1.53 episodes/year, with 95% of subjects having a model-estimated rate of 0.47–4.22 episodes/year. The overall ratio of severe exacerbations to total exacerbations was 0.22, with 95% of subjects having a model-estimated ratio of 0.04–0.60. We did not confirm an association between exacerbation rate and severity (P = 0.099). A unified model, implemented in standard software, could estimate joint heterogeneity in COPD exacerbation rate and severity and can have applications in similar contexts where inference on event time and intensity is considered. We provide SAS code (SAS Institute, Inc., Cary, North Carolina) and a simulated data set to facilitate further uses of this method.
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Soenjoyo, Karina Ruth, Nivedita Nadkarni, and Mariko Siyue Koh. "Comparison of exacerbation phenotypes among patients with severe asthma." Allergy and Asthma Proceedings 41, no. 4 (July 1, 2020): e67-e79. http://dx.doi.org/10.2500/aap.2020.41.200029.

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Background: Exacerbation phenotypes among patients with severe asthma have been largely characterized during stable periods. Little is known about severe asthma patients during exacerbation periods. Objective: To compare persistently frequent exacerbators (PFE), non‐persistently frequent exacerbators (NPFE), and infrequent exacerbators (IFE) among patients with severe asthma during stable and exacerbation periods. Methods: Patients with severe asthma who were admitted for asthma exacerbations from 2011 to 2017 and on follow up at Singapore General Hospital were recruited and categorized as PFEs (two or more exacerbations per year over 2 consecutive years), NPFEs (two or more exacerbations in 1 year only), or IFEs (fewer than two exacerbations per year over 2 consecutive years). Demographic, clinical, and laboratory data were collected at baseline and during exacerbation periods. Results: The participants were categorized as the following: 20 PFEs, 36 NPFEs, and 57 IFEs, with no significant demographic differences. The participants as PFEs (versus NPFEs and IFEs) were characterized by having a higher prevalence of psychiatric disorders (25% versus 8% versus 5%; p = 0.046), more comorbidities (7 versus 4 versus 2; p < 0.001), and a higher steroid burden per year (1150 versus 456 versus 350 mg; p < 0.001). The participants who were PFEs (versus IFEs) had a higher total immunoglobulin E (IgE) level (625 versus 232 IU/mL; p = 0.046) and longer duration of admission stay (3 versus 2 days; p = 0.009). All three groups had higher blood neutrophil counts during exacerbation periods than during stable periods (p = 0.008 versus p < 0.001 versus p = 0.004). Conclusion: The participants categorized as PFEs were characterized by comorbidities, higher steroid burden, IgE levels, and longer hospital stays. Exacerbations in the participants with severe asthma, regardless of exacerbation phenotype, were characterized by neutrophilia. These findings provided insights into potential therapeutic strategies to reduce exacerbations in patients with severe asthma.
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Nault, Diane, Maria F. Sedano, Lorena Soto, Alexandre Joubert, Isabelle Drouin, and Jean Bourbeau. "A Model Applied to a Real Life Situation: Self-Management with a Written Action Plan for Early Treatment of COPD Exacerbations." Clinical & Investigative Medicine 30, no. 3 (June 1, 2007): 44. http://dx.doi.org/10.25011/cim.v30i3.1750.

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Background: We hypothesized that self-management education with the use of a written action plan provided by a nurse case manager can help patients to gain the proper skills to start an early treatment for an acute exacerbation. Methods: COPD patients from an outpatient clinic with access to a written action plan and self-administered prescription were instructed to initiate their antibiotics and/or prednisone in case of exacerbation, and call their nurse case manager for supervision. The following data was collected: symptoms change, patients delay in taking action to treat their exacerbations (starting antibiotics and prednisone, calling the case manager) and use of hospital services. Results: We report on 187 exacerbations occurring in a cohort of 113 moderate / severe COPD patients with FEV1 of 37 ± 16% predicted (mean ± SD). 161 exacerbations were supervised by the case manager at the time of the event. The remaining 26 exacerbations were detected after the event. 87% of the supervised exacerbations presented with 2 major symptoms (increased dyspnea, increased sputum volume and/or purulent sputum). Patient’s delay to initiate treatment in supervised exacerbations was 2.04 ± 1.8 days; 85% took action to treat the exacerbation within 3 days. The treatment for supervised and unsupervised exacerbations was similar (slightly more antibiotics and prednisone were used for unsupervised ones) and they had similarly favourable outcomes in terms of health services use, with 68.5% of the exacerbations not requiring any hospital services. Conclusions: Patients can take an active role, acquire the skills to recognize exacerbation symptoms and start an early treatment of antibiotics and prednisone according to the directives of their written action plan.
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El Sawy, Ihab H., Reham M. Wagdy, Afaf G. Ibrahim, and Suzy W. Ibrahim. "Risk factors associated with severe asthma exacerbations in children attending Alexandria University Children’s Hospital, Egypt." International Journal Of Community Medicine And Public Health 5, no. 12 (November 24, 2018): 5019. http://dx.doi.org/10.18203/2394-6040.ijcmph20184670.

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Background: Severe asthma exacerbation is one of the common pediatric medical emergencies that necessitates hospital visits. The study aimed to identify risk factors associated with pediatric severe asthma exacerbations that might have the potential to guide the parents for early medical consultations and physicians at primary health care centers for proper management.Methods: A case-control study was conducted on over 100 asthmatic children below 12 years attending the Emergency Department of Alexandria University Children’s Hospital in acute exacerbation. Based on a modified pulmonary index score, the patients were allocated into 2 groups; study group (50 patients with severe asthma exacerbation) and control group (50 patients with mild asthma exacerbations). Demographic data, history of illness, alarming clinical signs, medications, and outcome of all participants were recorded.Results: Severe asthma exacerbations were more encountered among males, older age, and with a longer duration of asthma (X±SD=28.4±15.9 months) with significant differences when compared to controls. Comparing the studied groups revealed higher risk for severe asthma exacerbations mainly with; history of sudden onset of severe respiratory distress (Odds ratio “OR”=30.13, 95% CI, 13.78-66.69) and chronic steroid-dependent asthma (OR=14.46, 95% CI, 3.97-52.65). Cyanosis, lethargy, and inability to talk were alarming signs in patients with severe asthma exacerbation when compared to those with mild asthma exacerbation (p<0.05).Conclusions: Severe asthma exacerbation in children is still associated with many risk factors that may alert the patients’ caregivers and physicians prospectively for early proper management.
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FitzGerald, J. Mark, Peter J. Barnes, Bradley E. Chipps, Christine R. Jenkins, Paul M. O'Byrne, Ian D. Pavord, and Helen K. Reddel. "The burden of exacerbations in mild asthma: a systematic review." ERJ Open Research 6, no. 3 (July 2020): 00359–2019. http://dx.doi.org/10.1183/23120541.00359-2019.

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BackgroundAlthough most patients with asthma have mild disease, data on how mild asthma is defined, and how frequently exacerbations occur in this patient population are scarce, so we aimed to redress this.MethodsWe searched Medline and Medline In-Process (PubMed), and Embase in OVID for English-language publications containing “mild asthma” plus at least one relevant therapy and outcome/keyword, limited to randomised controlled trials (RCTs) and observational studies published between January 1990 and February 2019. Publications were filtered to ensure appropriate data extraction. The main outcomes were the definitions of mild asthma and exacerbations, baseline exacerbation rates and exacerbation data for placebo recipients in prospective studies. Meta-analysis of exacerbation rates was planned.FindingsOf 4064 articles identified, 64 were included in our review (49 743 subjects); 54 RCTs and 10 observational/other studies. Six main types of definitions of mild asthma were identified. While care was taken to ensure inclusion only of patients with mild asthma, marked heterogeneity was revealed in the definitions of mild asthma and hence the study populations. Reporting of exacerbations also varied widely between studies, precluding meta-analysis. Between 0–22% of patients were hospitalised for asthma or had a severe exacerbation in the previous year, according to baseline data from prospective studies. In RCTs, severe exacerbation rates in placebo recipients taking only short-acting β2-agonist therapy ranged from 0.20–2.88 per year.ConclusionsThese data provide new evidence of the burden of exacerbations in mild asthma and highlight the need for standardised definitions of mild asthma and of exacerbations to progress further research.
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Matsuse, Hiroto, Tomoko Tsuchida, Susumu Fukahori, Tetsuya Kawano, Shinya Tomari, Nobuko Matsuo, Tomoya Nishino, Chizu Fukushima, and Shigeru Kohno. "Retrospective Cohort Study of Leukotriene Receptor Antagonist Therapy for Preventing Upper Respiratory Infection-Induced Acute Asthma Exacerbations." Allergy & Rhinology 4, no. 3 (January 2013): ar.2013.4.0062. http://dx.doi.org/10.2500/ar.2013.4.0062.

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Upper respiratory tract infections (URIs) represent the most frequent cause of acute asthma exacerbations. It has yet to be determined whether leukotriene receptor antagonist (LTRA) treatment prevents URI-induced acute asthma exacerbations in adults. The objective of the present study was to evaluate the preventive effects of LTRA treatment on URI-induced acute asthma exacerbations. The incidences of URI alone, acute asthma exacerbation without URI, and URI-induced acute asthma exacerbation were determined retrospectively by analyzing diary and medical records of 321 adult asthmatic patients (mean age, 56.3 ± 17.2 years; male/female ratio, 117:204) over 1 year. Results were compared between patients who had been taking an LTRA (n = 137) and those who had never taken any LTRA (n = 184) during the study periods. Significantly fewer URIs alone and acute asthma exacerbations without URI occurred in patients with than in those without prophylactic daily use of LTRA. LTRA treatment significantly reduced the durations of URIs alone and of total acute asthma exacerbations, as well as the incidence of mild exacerbations of asthma. In contrast, in patients with URI-induced acute asthma exacerbations, LTRA treatment failed to significantly reduce the interval between URI onset and acute asthma exacerbation, as well as the duration and severity of both URIs and acute asthma exacerbations. Use of an LTRA for adult asthmatic patients appears to reduce the incidences of URIs alone and acute asthma exacerbations without URI, but it failed to prevent URI-induced acute asthma exacerbations once a URI occurred.
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Nurhayati, Dewi, Ida Parwati, Tiene Rostini, and Arto Yuwono. "KADAR SURFACTANT PROTEIN-D SERUM PADA PASIEN PENYAKIT PARU OBSTRUKTIF KRONIS BERKEBAHAYAAN KAMBUHAN RENDAH DAN TINGGI." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 22, no. 2 (March 27, 2018): 168. http://dx.doi.org/10.24293/ijcpml.v22i2.1122.

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Chronic obstructive pulmonary disease (COPD) cause high morbidity and mortality worldwide. The exacerbations in chronicobstructive pulmonary disease accelerate the decline in lung function and health status, as well as in increasing the treatment cost andmortality risk. The spiro metric measurement has several limitations in assessing the severity as well as the exacerbation risk in COPDpatients. Currently, has been available serum surfactant protein-D, a marker of lung inflammation and lung tissue damage. This proteinis produced by the alveolar type II cells and the Clara cells that play role in maintaining the lung stability and pulmonary immunesystem. The increased level of serum SPD indicates that there is lung epitihelial leakage in line with COPD severity increment and reflectedin COPD exacerbation level of risk according to combined COPD assessment GOLD criteria of the year 2011. The aim of this study wasto know the differences of SP-D serum levels between low and high risk of exacerbation in COPD patients by determination them. Thisstudy was conducted from March to July 2014. The subjects of this study were COPD patients diagnosed by spiro metric measurement.The research was conducted in comparative analytic way with a cross sectional study design. The statistical analysis was performedusing Mann-Whitney non-parametric test. The subjects were 62 COPD patients. The SP-D serum level at low risk of exacerbation groupdiffer significantly compared to the high risk exacerbation group, 1.8–68.4 ng/mL and 3.36–116.4 ng/mL respectively (P=0.018).Based on this study it can be concluded that the SP-D serum levels were higher in COPD patients with high risk exacerbation than thelower risk one. The SP-D serum levels may be considered as a specific marker of lung tissue injury to assess the risk of the exacerbationin COPD patients.
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Dissertations / Theses on the topic "Exacerbationer"

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Figueiredo, Neves Ferreira Rita Nair. "Fysioterapeutiska insatser och interprofessionell samverkan för personer med KOL inom privata och offentliga vårdcentraler i tre regioner i Sverige : En webbenkätstudie." Thesis, Umeå universitet, Avdelningen för fysioterapi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-183906.

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Introduktion: Majoriteten av personer med kroniskt obstruktiv lungsjukdom (KOL) diagnosticeras och behandlas inom primärvården i Sverige och enligt Socialstyrelsens riktlinjer bör interprofessionell samverkan (IPS) erbjudas. Fysioterapeuter har en viktig roll i KOL-behandling. Däremot är det fortfarande oklart vilka fysioterapeutiska insatser som används för personer med KOL i Sverige inom primärvården samt om insatserna skiljer sig mellan privata och offentliga vårdcentraler. Syftet med studien var att kartlägga fysioterapeutiska insatser för personer med KOL inom privata och offentliga vårdcentraler i tre regioner i Sverige. Ett delsyfte var att undersöka i vilken utsträckning dessa vårdcentraler erbjuder IPS. Metod: Tvärsnittsundersökning med enkät i webbformat med slutna frågor. Webbenkäten riktade sig till alla fysioterapeuter (n=289) som arbetade på privata och offentliga vårdcentraler i Region Västmanland, Sörmland och Örebro. Resultat: 96 fysioterapeuter deltog i studien. De mest använda fysioterapeutiska insatserna för personer med KOL var sex minuters gångtest, erbjudandet av träning på vårdcentraler, instruktion av andningsteknik och andningsgymnastik. Privata vårdcentraler erbjöd mest träning vid klinik och offentliga vårdcentraler utförde mest sex minuters gångtester. Resultaten visade på ojämlik användning av IPS mellan och inom regionerna. Slutsats: Studien visar att utvecklingspotential finns gällande användning av fysioterapeutiska insatser och IPS på vårdcentralerna för att kunna följa Socialstyrelsens riktlinjer och erbjuda en jämlik vård för personer med KOL i Sverige.
Introduction: Most of the diagnosis and treatment for individuals with chronic obstructive pulmonary disease (COPD) take place in primary care centers in Sweden, and according to the Swedish National Health guidelines, interprofessional collaboration (IPC) should be offered to individuals with COPD. Physiotherapists have an important role in the treatment of COPD. However, it is still unclear which physiotherapeutic interventions are used in primary care and whether these interventions differ between private and public health care centers (HCC). The aim of this study was to identify which physiotherapeutic interventions are used for individuals with COPD in private and public HCC in three regions in Sweden. This study also investigated to what extent HCC are offering IPC. Methods: A cross-sectional study with an online format with closed-end questions. The online survey was aimed to reach all physiotherapists (n = 289) who worked at HCC in Västmanland, Sörmland and Örebro. Results: 96 physiotherapists participated in the study. The most used physiotherapeutic interventions for people with COPD were the six-minute walk test (6MWT), offer of training at HCC, instruction in breathing techniques and breathing exercises. Private HCC offered mostly exercise training and the public HCC mostly 6MWT. The results also show differences in healthcare interventions and IPC between and within the regions. Conclusion: The study shows that there is room for improvement regarding use of physiotherapeutic interventions and IPC in HCC in order to follow the National Health guidelines and offer equal care for individuals with COPD in Sweden.
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Hanna, Bano. "Får KOL-patienter färre exacerbationer om de behandlas medtiotropium i sprayinhalator jämfört med pulverinhalator? - En litteraturstudie." Thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-385929.

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Patel, Irem S. "Mechanisms of exacerbations and exacerbation frequency in chronic obstructive pulmonary disease." Thesis, Queen Mary, University of London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510887.

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Bathoorn, Derk. "COPD exacerbations, inflammation and treatment." [S.l. : Groningen : s.n. ; University Library of Groningen] [Host], 2007. http://irs.ub.rug.nl/ppn/304982296.

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Sheikh, Omer, MohD Ibrahim, Joseph Maguire, Shama Bano, Pradnya Bhattad, Dhruvil Radadiya, Amiksha Kad, et al. "COPD exacerbation induced Takotsubo Cardiomyopathy." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/75.

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Introduction: Takotsubo cardiomyopathy or stress cardiomyopathy is a syndrome of transient left ventricular (LV) dysfunction mimicking myocardial infarction, but lacking obstruction of coronary artery disease (CAD) or acute plaque rupture. A characteristic differentiation from CAD is that regional motional abnormality extends beyond a territory perfused with a single epicardial coronary artery. Clinically, it is characterized by apical ballooning of the LV due to due to depression of mid and apical segments, with hyperkinesis of cardiac basal walls. Women are affected more than men, predominantly in the postmenopausal age. Case Report: A 54-year-old Caucasian female with a history of COPD, hypertension, uncontrolled diabetes mellitus, hyperlipidemia, depression and ongoing tobacco use presented with complaints of worsening shortness of breath two days prior to admission. She denied chest pain, worsened cough, palpitations, nausea or vomiting. On examination, she was in distress and anxious, with labored breathing. Upon examining the chest, decreased air entry was present in both lung fields with bibasilar wheezing. Initial lab tests showed mild respiratory acidosis, with pH of 7.24, pCO2 of 47.4 and pO2 of 65. Troponins on the day of admission was Soon after admission, she started complaining of severe right neck pain. Repeat EKG revealed localized lateral J point, anteroseptal q waves and 4mm ST-segment elevation in leads V3 and V4 reciprocal changes and without chest pain. Repeat troponins were slightly elevated to 0.42 ng/ml and CK-MB was elevated to 20.2 ng/ml. A transthoracic echocardiogram showed regional abnormalities in left ventricle with the apex, mid to distal septum and the anterior part of septum was akinetic. Discussion: Takotsubo cardiomyopathy presents in 1 to 2 percent of troponin-positive acute coronary syndrome (ACS) with various clinical manifestations and various outcomes. Some patients have favorable outcomes based on their clinical performance and extent of cardiac muscle involvement. As in the case we presented, this syndrome can be entirely idiopathic, without a definitive underlying cause. Supportive management while hospitalized and early identification of complications improve the prognosis.
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Johansson, Fanny, and Alexandra Djärf. "Personers upplevelse av KOL-exacerbation." Thesis, Luleå tekniska universitet, Omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-66951.

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Kronisk obstruktiv lungsjukdom även förkortat KOL, är en progressiv sjukdom ofta orsakat av tobaksrökning. KOL är en vanligt förekommande sjukdom hos patienter inom vården. Sjukdomen har stor påverkan på personens vardagliga liv och påverkar livskvaliteten på ett negativt sätt. En exacerbation är ett försämringstillstånd i grundsjukdomen KOL. Syftet med denna litteraturstudie var att beskriva personers upplevelse av en KOL- exacerbation. Resultatet baseras på elva vetenskapliga artiklar hämtade från Pubmed och Cinahl. Dessa har analyserats med kvalitativ innehållsanalys. Fyra huvudteman framkom genom analysen av de elva artiklarna: Att begränsas av rädsla och bristande ork; Att vara maktlös och inte bli tagen på allvar; Att kunskap, kontroll och gemenskap ger trygghet; Att känna skuld och skam för att själv orsakat sjukdomen. I resultatet framkom att exacerbationer var väldigt påfrestande då andnöd skapar stor ångest och oro. Det var även vanligt att känna en maktlöshet i sin situation och försämringar i grundsjukdomen innebar en hel del begränsningar i vardagen. Personer med kunskap i sin sjukdom hade bättre förutsättningar att hantera en excacerbation. Det var viktigt att som sjuksköterskan ha en förmåga att se hela människan och göra personen delaktig i sin vård och behandling. Sjuksköterskans kunskap och bemötande spelade en viktig roll i omvårdnaden genom att skapa trygghet.
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Quint, J. K. "Determinants of exacerbation frequency in COPD." Thesis, University College London (University of London), 2010. http://discovery.ucl.ac.uk/20188/.

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Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous collection of conditions characterized by irreversible expiratory airflow limitation. The disease is interspersed with exacerbations; periods of acute symptomatic, physiological and functional deterioration. There are large differences in yearly exacerbation incidence rates between patients of similar COPD severity giving rise to the concept of two distinct phenotypes; frequent and infrequent exacerbators. This thesis hypothesizes that frequent exacerbators are a distinct phenotype of COPD, and identifies some of the factors that influence exacerbation frequency. Method: 356 individuals from the London COPD cohort were included in the analyses in different subgroups. All patients completed daily diary cards and reported exacerbations to the study team for sampling and treatment. Blood and sputum were collected in the stable state and at exacerbation. Samples were processed for cytokines, genetic polymorphisms and viruses. A subset of patients also had endobronchial biopsies for epithelial cell work and immunohistochemistry. Results: Patient reported exacerbation frequency can be used to accurately stratify patients into frequent and infrequent exacerbators groups in subsequent years. Frequent exacerbators were more depressed and more likely to be female then infrequent exacerbators. There was no difference in social contacts, HRV positivity or load in sputum, Vitamin D levels, or cytokine variability between frequent and infrequent exacerbators. No differences in genetic polymorphisms (ICAM-1, IL-6, IL-8, VDR, Taq1 α1 –antitrypsin) were identified between the two groups. Conclusions: The frequent exacerbator phenotype exists. There is not one single determinant of exacerbation frequency, and determinants vary with underlying disease severity.
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Gilkey, Justin Michael. "Exacerbation and Attenuation of Ego-Depletion." Bowling Green State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1352056734.

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Habibzay, Maryam. "Asthma induced exacerbation of bacterial pneumonia." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/29847.

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Asthma and bacterial pneumonias are major causes of human mortality and morbidity throughout the world. To date many studies have investigated the possibility that bacteria exacerbate asthma but only a handful consider that asthma may cause bacterial infections. Recent clinical evidence suggests that bacterial infections cause serious complications in patients with asthma and that asthmatics show a 2-fold increased risk of invasive pneumococcal disease. This thesis examines the molecular mechanisms causing susceptibility of house dust mite (HDM) exposed lungs to bacterial infection. The main finding of this thesis is that HDM-induced allergic airways disease increases susceptibility to Streptococcus pneumoniae infection. Furthermore, the molecular pathways leading to the production of neutrophil chemoattractants in the lung are compromised and that despite the complexity of anti-bacterial pathways that are disrupted, the re-introduction of a single chemokine to the lungs with allergic airway disease enables clearance of S. pneumoniae that would otherwise prove fatal. However, a reduction in HDM-induced eosinophilia seen in ST2 deficient mice does not restore anti-bacterial immunity. This deficit in anti-bacterial immunity in HDM exposed lungs is associated with a change in resident alveolar macrophages into an alternatively activated phenotype, characterised by high mRNA and protein levels of RELMα, Ym1 and Arg1. These altered alveolar macrophages produce considerably less TNFα in response to Toll-Like Receptor (TLR) stimulation that is not a result of reduced TLR mRNA levels but due to an upregulation of TLR negative regulators particularly A20. A20 targets TRAF-6 that is found upstream of NF-κB activation. To prove a causal link naïve alveolar macrophages were transferred into allergic lungs prior to bacterial infection; such lungs handled the infection better confirming that alveolar macrophages are important in initiating the anti-bacterial response. Overall our findings highlight a change in specific innate immune pathways in the allergic lung that participate in susceptibility to bacterial pneumonia.
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Bihl, Eva-Britt, and Lillemor Söderman. "Nutritionens betydelse för patienter med KOL - Kronisk Obstruktiv Lungsjukdom : Metoder för sjuksköterskans bedömning av nutritionsstatus." Thesis, Högskolan Dalarna, Omvårdnad, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:du-3274.

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Syftet med denna studie var att belysa hur viktig nutritionen är för patienter med diagnosen KOL (Kronisk Obstruktiv Lungsjukdom). Författarna ville även visa på enkla metoder för sjuksköterskan att bedöma nutritionsstatus för att förebygga malnutrition hos dessa patienter. Denna studie är en systematisk litteraturstudie där författarna använt sig av databaserna ELIN@Dalarna, CINAHL, Blackwell Synergy och SWEMED+ för att söka vetenskapliga artiklar. Sökorden som användes i olika kombinationer var: COPD, nutrition, malnutrition, undernutritioned, nutritionalstatus, nutritional supplement, BMI, energy expenditure, caring och nursing. Resultatet visade att nutritionen är av central betydelse i behandlingen av KOL patienter där sjuksköterskan har en viktig roll i samarbetet med andra yrkeskategorier såsom läkare, dietist, sjukgymnast, arbetsterapeut, kurator och psykolog. Bedömningen av patientens nutritionsstatus är en väsentlig del av sjuksköterskans omvårdnad av KOL patienter då det påverkar prognosen. Patienternas försämrade nutritionsstatus ökar risken för exacerbationer och därmed också risken för dödlighet.Sjuksköterskan kan använda sig av enkla mätmetoder för att upptäcka malnutrition, till exempel BMI (Body Mass Index) och MNA (Mini Nutritional Assessment). Ett steg i att förebygga malnutrition är regelbundna viktkontroller och att varje patient har en individuell åtgärdsplan då patientens behov alltid ska komma i första hand. Det är också viktigt att se till psykosociala aspekter runt måltiderna för dessa patienter. En noggrann planering krävs runt deras måltider som patienten kan behöva hjälp med då sjukdomen utgör ett hinder.För en ökad livskvalitet är det angeläget med information om nutritionens betydelse både till patienten och hans anhöriga.
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Books on the topic "Exacerbationer"

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Cazzola, Mario. Acute exacerbations in COPD. Oxford: Clinical Pub., 2009.

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Schmidt-Weber, Carsten B., ed. Allergy Prevention and Exacerbation. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-69968-4.

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Acute exacerbation of respiratory diseases. New Delhi: Jaypee Brothers Medical Publishers, 2012.

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Allegra, Luigi, and Francesco Blasi, eds. Mechanisms and Management of COPD Exacerbations. Milano: Springer Milan, 2000. http://dx.doi.org/10.1007/978-88-470-2115-0.

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Ning, Qin, ed. Acute Exacerbation of Chronic Hepatitis B. Dordrecht: Springer Netherlands, 2019. http://dx.doi.org/10.1007/978-94-024-1603-9.

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Ning, Qin, ed. Acute Exacerbation of Chronic Hepatitis B. Dordrecht: Springer Netherlands, 2019. http://dx.doi.org/10.1007/978-94-024-1606-0.

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Barbara, Forey, ed. Exacerbation of asthma: Epidemiological evidence in children. New York: Nova Science, 2008.

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Luan, Xiujie. Study of the bacteria associated with exacerbation of late-onset asthma. [Derby: University of Derby], 2000.

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Dia, Mamadou. L' exacerbation de la crise: Au Sénégal, en Afrique, dans le monde. [Dakar]: Grenier du patriarche, 2004.

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Lehmann, Harold P. Practice parameter: The treatment of acute exacerbations of asthma in children : technical report. Elk Grove Village, IL: The Academy, 1994.

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Book chapters on the topic "Exacerbationer"

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Montemayor, Kristina, Allison A. Lambert, and Natalie E. West. "Pulmonary Exacerbations." In Respiratory Medicine, 181–98. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-42382-7_9.

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Champion, Howard R., Nova L. Panebianco, Jan J. De Waele, Lewis J. Kaplan, Manu L. N. G. Malbrain, Annie L. Slaughter, Walter L. Biffl, et al. "Asthma Exacerbation." In Encyclopedia of Intensive Care Medicine, 274. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_1171.

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Marik, Paul Ellis. "COPD Exacerbation." In Evidence-Based Critical Care, 373–79. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-11020-2_24.

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Marik, Paul Ellis. "COPD Exacerbation." In Handbook of Evidence-Based Critical Care, 253–59. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-1-4419-5923-2_22.

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Wedzicha, Jadwiga A. "Mechanisms of Exacerbations." In Chronic Obstructive Pulmonary Disease: Pathogenesis to Treatment, 84–103. Chichester, UK: John Wiley & Sons, Ltd, 2008. http://dx.doi.org/10.1002/0470868678.ch6.

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Adams, Sandra G., and Antonio Anzueto. "Exacerbations of COPD." In COPD, 191–209. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-59745-357-8_11.

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Mineshita, Masamichi. "Exacerbation of COPD: Why Do Exacerbations of COPD Attract Attention? Are There Any Preventive Methods?" In Respiratory Disease Series: Diagnostic Tools and Disease Managements, 279–95. Singapore: Springer Singapore, 2016. http://dx.doi.org/10.1007/978-981-10-0839-9_15.

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Polverino, Eva, Edmundo Rosales-Mayor, and Antoni Torres. "Exacerbation of Bronchiectasis." In Bronchiectasis, 205–22. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-61452-6_15.

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Rana, Abdul Qayyum, and John Anthony Morren. "Multiple Sclerosis (Exacerbation)." In Neurological Emergencies in Clinical Practice, 89–93. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-5191-3_10.

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Lee, Jin Hwa. "Exacerbation of COPD." In COPD, 261–66. Berlin, Heidelberg: Springer Berlin Heidelberg, 2017. http://dx.doi.org/10.1007/978-3-662-47178-4_18.

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Conference papers on the topic "Exacerbationer"

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Tine, Mariaenrica, Graziella Turato, Kim Lokar Oliani, Erica Bazzan, Umberto Semenzato, Davide Biondini, Matteo Bonato, Marina Saetta, and Manuel G. Cosio. "Acute exacerbation of COPD in Emergency Room: just COPD exacerbations?" In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa5220.

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Cushen, Breda, Garrett Greene, Elaine Mac Hale, Lorraine Tompkins, Imran Sulaiman, Fiona Boland, Emer Kelly, and Richard W. Costello. "Clinical and exacerbation characteristics may predict treatment response in acute exacerbations of COPD." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4094.

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Krishnan, J. K., C. Oromendia, I. Easthausen, H. Muellerova, I. Barjaktarevic, R. G. Barr, R. P. Bowler, et al. "A Symptom-Based Approach to Defining Exacerbations Suggests High Burden of Exacerbation Events in SPIROMICS." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5035.

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Fletcher, Matthew D., B. S. Prato, Jonathan B. Zuckerman, Karen Jarosz, and Scott Morin. "Use Of A Pulmonary Exacerbation Score (PES) To Improve Treatment Of Adult Cystic Fibrosis Pulmonary Exacerbations." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1826.

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Rothnie, Kieran, Hana Müllerová, Liam Smeeth, Neil Pearce, Ian Douglas, and Jennifer Quint. "Risk of myocardial infarction (MI) associated with acute exacerbations of COPD (AECOPD): Effects of exacerbation frequency." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa3107.

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Sobotik, Ondrej, Miloslav Marel, Alena Vlachova, Frantisek Petrik, and Dmitry Rakita. "Acute exacerbations of COPD: The influence of comorbidities and chronic medication on mortality and exacerbation rate." In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa657.

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Calverley, P. M., C. Jenkins, J. A. Wedzicha, A. de la Hoz, F. Voss, K. F. Rabe, and A. Anzueto. "Treatment of First Exacerbation Predicts Future Risk of Exacerbations in Patients with COPD in the DYNAGITO Trial." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a7101.

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Wedzicha, JA, JR Hurst, J. Vestbo, A. Anzueto, R. Tal-Singer, J. Yates, and DP Miller. "Comparison of Perceived Exacerbation Frequency in COPD Patients and Actual Number of Exacerbations – Data from the ECLIPSE Study." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a1528.

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Ferrera, M., C. L. Lopez, S. Murray, R. G. Jain, W. W. Labaki, B. J. Make, and M. K. Han. "Routinely Collected Clinical Features Are Associated with COPD Exacerbations in Individuals Without an Exacerbation History: A COPDGene Analysis." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2293.

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Sadatsafavi, M., A. Adibi, T. Y. Lee, D. D. Sin, and A. Safari. "Recalibration and External Validation of Acute COPD Exacerbation Predictor (ACCEPT): Improving the Prediction of Acute Exacerbations of COPD." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1129.

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Reports on the topic "Exacerbationer"

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Dobler, Claudia C., Allison S. Morrow, Magdoleen H. Farah, Bradley Beuschel, Abdul M. Majzoub, Michael E. Wilson, Bashar Hasan, et al. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2019. http://dx.doi.org/10.23970/ahrqepccer221.

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Kuroda, Hiroaki. Presurgical heterogeneity of lung 18FDG-PET uptake predicts acute exacerbation of interstitial lung disease following pulmonary resection in patients with smoke exposures. Science Repository OU, July 2019. http://dx.doi.org/10.31487/j.jso.2019.02.08.

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Wen, Li, Chai Yihui, Qin Zhong, Gao Jie, Guan Liancheng, Zhang Mengzhi, Liu Huaiquan, et al. Association of metformin use with asthma exacerbation in patients with concurrent asthma and diabetes: a systematic review and meta-analysis of observational studies. International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0210.

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LEI, XING, and HONGMIN GUO. The effects of Su-Zi-Jiang-Qi decoction (SZJQ) in acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2021. http://dx.doi.org/10.37766/inplasy2021.6.0115.

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Xing, Lei, Hongmin Guo, and Zhiqian Wang. Efficacy and safety of Suzi Jiangqi Decoction in patients with acute exacerbation of chronic obstructive pulmonary disease A protocol for systematic review and meta analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2021. http://dx.doi.org/10.37766/inplasy2021.8.0035.

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Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic respiratory symptoms. The respiratory symptoms of patients with acute exacerbation of COPD (AECOPD) worsen rapidly. At present, traditional western medicine treatment can not effectively alleviate the symptoms and attack frequency of patients. Suzi Jiangqi decoction(SZJQ) has a good clinical effect in the treatment of AECOPD. Due to the lack of evidence-based medicine, it can not provide an effective systematic evaluation for the treatment of AECOPD with Suzi Jiangqi decoction. Therefore, it is necessary to provide high-quality evidence evaluation for the clinical efficacy and safety of Suzi Jiangqi Decoction in the treatment of AECOPD. Methods: Two researchers independently retrieved randomized controlled trial (RCT) and quasi-RCTs of SZJQ in the treatment of AECOPD from databases including PubMed, Web of science, the Cochrane Library, CBM, CNKI, Sinomed, VIP and WanFang.The included studies were evaluated for quality according to the RCT quality assessment method provided by Cochrane Reviewer's Handbook 5.3.Review Manager 5.3 software provided by the Cochrane collaboration was used for meta-analysis. Results: This study will provide systematic review on the efficacy and safety of SZJQ as adjuvant therapy in patients with AECOPD by rigorous quality assessment and reasonable data synthesis. Conclusions: This systematic review will provide the good evidence currently on SZJQ as adjuvant therapy in patients with AECOPD.
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Ren, Huijun, Yuhao Jiang, Shiyu Wang, Yirong Wang, and Jingying Wang. Efficacy and safety of Shufeng Jiedu Capsule in the treatment of acute exacerbations of chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2020. http://dx.doi.org/10.37766/inplasy2020.12.0062.

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Teng, Wenzhe, Hu Chen, Siyao Shi, Yin Wang, and Kangyao Cheng. Effect of bilevel continuous positive airway pressure for patients with type II respiratory failure due to acute exacerbation of COPD: A protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2020. http://dx.doi.org/10.37766/inplasy2020.11.0003.

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Yentis, S. M., K. Asanati, C. R. Bailey, R. Hampton, I. Hobson, K. Hodgson, S. Leiffer, S. Pattani, and K. Walker-Bone. Better musculoskeletal health for anaesthetists. Association of Anaesthetists, June 2021. http://dx.doi.org/10.21466/g.bmhfa.2021.

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3Association of Anaesthetists | Better musculoskeletal health for anaesthetistsSummaryWork-related musculoskeletal disorders are very common amongst healthcare workers, and there is evidence that anaesthetists are at greater risk of upper limb disorders than other groups. This guidance aims to bring together advice and recommendations from a variety of sources in order to inform and support anaesthetists at work, in an attempt to reduce the prevalence and severity of work-related musculoskeletal disorders and the exacerbation of pre-existing disorders. Mechanical and psychosocial risk factors for work-associated musculoskeletal disorders are summarised, along with general principles for achieving better musculoskeletal health and practices specific to areas of the body most at risk. These include recommended exercises and stretches during sedentary work.RecommendationsAttention must be paid by both employers and anaesthetists to the physical and psychological risk factors that may lead to development and/or exacerbation of musculoskeletal disorders. This requires ongoing risk assessments and adherence to published standards of health and safety at work, including training. Such a programme is best achieved as part of a multidisciplinary approach.What other guidelines are available on this topic? There are many sources of guidance on health and safety in the workplace, across many sectors, much of which is of relevance to anaesthetists. There is no readily accessible guidance specifically aimed at the anaesthetic workplace.Why was this guideline developed?This guidance was developed as part of a wider piece of work by the Association of Anaesthetists based around ergonomics of the anaesthetic workplace, as a result of the increased reported incidence of musculoskeletal disorders amongst anaesthetists. It aims to draw on existing guidance and present a summary of advice relevant to anaesthetists and their practice.How and why does this publication differ from existing guidelines?This guidance summarises other advice and recommendations, and focuses on factors relevant to the anaesthetic workplace
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Brown, Yolanda, Twonia Goyer, and Maragaret Harvey. Heart Failure 30-Day Readmission Frequency, Rates, and HF Classification. University of Tennessee Health Science Center, December 2020. http://dx.doi.org/10.21007/con.dnp.2020.0002.

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30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who are readmitted within 30 days from prior hospitalization for heart failure. Hospitals risk losing millions of dollars due to poor performance. A reduction in CHF readmission rates not only improves healthcare system expenditures, but also patients’ mortality, morbidity, and quality of life. Purpose The purpose of this DNP project is to determine the 30-day hospital readmission rates, frequencies, and heart failure classification for patients with heart failure. Specific aims include comparing computed annual re-admission rates with national average, determine the number of multiple 30-day re-admissions, provide descriptive data for demographic variables, and correlate age and heart failure classification with the number of multiple re-admissions. Methods A retrospective chart review was used to collect hospital admission and study data. The setting occurred in an urban hospital in Memphis, TN. The study was reviewed by the UTHSC Internal Review Board and deemed exempt. The electronic medical records were queried from July 1, 2019 through December 31, 2019 for heart failure ICD-10 codes beginning with the prefix 150 and a report was generated. Data was cleaned such that each patient admitted had only one heart failure ICD-10 code. The total number of heart failure admissions was computed and compared to national average. Using age ranges 40-80, the number of patients re-admitted withing 30 days was computed and descriptive and inferential statistics were computed using Microsoft Excel and R. Results A total of 3524 patients were admitted for heart failure within the six-month time frame. Of those, 297 were re-admitted within 30 days for heart failure exacerbation (8.39%). An annual estimate was computed (16.86%), well below the national average (21%). Of those re-admitted within 30 days, 50 were re-admitted on multiple occasions sequentially, ranging from 2-8 re-admissions. The median age was 60 and 60% male. Due to the skewed distribution (most re-admitted twice), nonparametric statistics were used for correlation. While graphic display of charts suggested a trend for most multiple re-admissions due to diastolic dysfunction and least number due to systolic heart failure, there was no statistically significant correlation between age and number or multiple re-admissions (Spearman rank, p = 0.6208) or number of multiple re-admissions and heart failure classification (Kruskal Wallis, p =0.2553).
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Treating vitamin D deficiency may reduce exacerbations of COPD. National Institute for Health Research, February 2019. http://dx.doi.org/10.3310/signal-000737.

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