De 1-jaars mortaliteit van patiënten opgenomen in het MST met een exacerbatie COPD.

Bosscher, K. (Kirsten) (2014) De 1-jaars mortaliteit van patiënten opgenomen in het MST met een exacerbatie COPD. thesis, Medicine.

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Abstract

Background: patients with exacerbations of COPD can be treated in the hospital in three different ways, the standard treatment, the standard treatment + NIV on the pulmonary ward and ICU admission + standard treatment. This study examined the 1-years mortality and the influence of lung function, need for help, resuscitation policy and the numbers of hospital admission before and after this admission. There was also attention for the impact of the hospital admission on the lung function, independence and resuscitation policy. Methods: A retrospective study of 229 patients who were divided into the three different treatment options. Results: the 1-years mortality for patients with standard treatment was 12,3%, for standard treatment + NIV on the pulmonary ward 41,5% and for ICU admission + standard treatment 29,4%. If the group patients with NIV was split then was de 1-years mortality for patient with NIV as best possible treatment 33,3% and for patient with NIV as a experiment 75%. This 1-years mortality was further influenced by having an previous hospital admission for exacerbation (increase 1.2x) and by change of need for help in daily care (increase 2.9x). The FEV1 was significantly reduced with standard treatment (50 ml) and with the standard treatment + NIV on the ward (80 ml). The need for help for daily care reduced after a hospital admission in all treatment options. It is reduced in the standard treatment group with 35 patients (22.9%), in the standard treatment + NIV on the department group with 18 patients (48,6%) and in de and IC recording + standard treatment group with 12 patients (42,9%). In all treatment options was the resuscitation policy after an hospital admission more often discussed. In the standard treatment was this in 81 patients (53%) more often discussed, in the standard treatment + NIV on department in 11 patients (27%) and in the IC-recording + NIV in 21 patients (62%). Conclusion: The lowest 1-years mortality was found in the standard treatment, and the highest in the NIV as palliative treatment. The NIV as best possible treatment had, in comparison with the IC-recording, a comparable 1-years mortality. But in comparison with the standard treatment it had a higher 1-years mortality.

Item Type:	Thesis (Thesis)
Supervisor name:	Beurden, Dr. W. van and Hagmolen-of ten Have, Dr. W.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1026

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