Table 2 Clinical characteristics and quality of care received among emergency department patients with an acute exacerbation of chronic obstructive pulmonary disease, according to time period
Variables | Period 1: 2000 (n = 72) | Period 2: 2005–2006 (n = 200) | Difference in means or proportions (95% CI) |
|---|---|---|---|
Baseline clinical characteristic | |||
Age, years | 71 ± 9 | 72 ± 9 | 1 (−2 to 3) |
Female sex | 36/72 (50) | 101/200 (51) | 1 (−13 to 14) |
White | 58/68 (85) | 156/200 (78) | −7 (−17 to 3) |
Current or former smoker | 68/71 (96) | 154/183 (84) | −12 (−5 to −19) |
Home oxygen use | 15/47 (32) | 72/200 (36) | 4 (−11 to 19) |
Acute exacerbation | |||
Duration of symptoms ≥ 24 h | 56/69 (81) | 138/164 (84) | 3 (−8 to 14) |
Triggered by respiratory infection | 45/69 (65) | 116/196 (59) | −6 (−19 to 7) |
Respiratory rate, breaths/min | 26 ± 7 | 23 ± 6 | 3 (1 to 5) |
O2 saturation on room air, %a | 89 ± 10 | 92 ± 6 | 4 (1 to 7) |
Process of care | |||
Recommended | |||
Chest radiography | 72/72 (100) | 196/200 (98) | −2 (−5 to 3) |
Pulse oximetry | 72/72 (100) | 199/200 (99.5) | −0.5 (−3 to 5) |
Arterial blood gasb | 14/58 (24) | 12/166 (7) | −17 (−5 to −27) |
Received inhaled bronchodilators in ED | 59/71 (83) | 180/200 (90) | 7 (−3 to 17) |
Received systemic corticosteroids in ED | 38/72 (53) | 154/200 (77) | 24 (11 to 37) |
Received antibiotics in EDc | 25/45 (56) | 90/116 (78) | 22 (6 to 38) |
Sent home on systemic corticosteroidsd | 6/11 (55) | 13/31 (42) | −13 (−22 to 47) |
Not recommended | |||
Spirometrye | 7/35 (20) | 19/200 (10) | −11 (−24 to 3) |
Received methylxanthines in ED | 0 | 0 | 0 |
ED disposition | |||
Hospital admissionf | 58/72 (81) | 166/200 (83) | 2 (−8 to 13) |