PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmcpmBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Pulmonary Medicine
 
BMC Pulm Med. 2012; 12: 27.
Published online 2012 June 22. doi:  10.1186/1471-2466-12-27
PMCID: PMC3479064

Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation

Abstract

Background

Exacerbations, a leading cause of hospitalization in patients with chronic obstructive pulmonary disease (COPD), affect the quality of life and prognosis. Treatment recommendations as provided in the evidence-based guidelines are not consistently followed, partly due to absence of simplified task-oriented approach to care. In this study, we describe the development and implementation of a clinical pathway (CP) and evaluate its effectiveness in the management of COPD exacerbation.

Methods

We developed a CP and evaluated its effectiveness in a non-randomized prospective study with historical controls on patients admitted for exacerbation of COPD to Universiti Kebangsaan 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.

Results

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). We did not find any significant differences in readmission and mortality rates.

Conclusion

The implementation of CP –reduced the length of stay and complication rates of patients hospitalized for acute exacerbation of COPD.

Keywords: Chronic obstructive pulmonary disease, Clinical pathway, Clinical outcomes, Length of stay

Articles from BMC Pulmonary Medicine are provided here courtesy of BioMed Central