Associated factors, assessment, management, and outcomes of patients who present to the emergency department for acute exacerbation of chronic obstructive pulmonary disease: A scoping review

Phillips, Tania M. and Moloney, Clint ORCID: https://orcid.org/0000-0003-2520-1506 and Sneath, Emily and Beccaria, Gavin ORCID: https://orcid.org/0000-0002-4341-804X and Issac, Hancy and Mullens, Amy B. ORCID: https://orcid.org/0000-0002-0939-9842 and Gow, Jeff ORCID: https://orcid.org/0000-0002-5726-298X and Rana, Rezwanul and King, Alex (2022) Associated factors, assessment, management, and outcomes of patients who present to the emergency department for acute exacerbation of chronic obstructive pulmonary disease: A scoping review. Respiratory Medicine, 193:106747. pp. 1-13. ISSN 0954-6111


Abstract

Objective: The purpose of the scoping review was to examine the extant literature for factors contributing to presentations of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) to Emergency Departments (ED). Methods: The review followed Arksey and O'Malley, and Levac's frameworks supplemented with the PRISMA-ScR checklist. We searched Cochrane Library, CINAHL, JBI, and PubMed from January 1, 2008 to March 23, 2020 for inclusions. We included studies reporting ED presentations for AECOPD among adults (≥18 years). The investigation included: pre-hospital factors; ED-related assessment, management and referral practices; holistic management (i.e., interdisciplinary); patient outcomes, admission/discharge status, and readmission. Results: Forty-four studies were included. Environmental factors (e.g., air pollution, seasonal change); social determinants (e.g., poor literacy, ethnicity); and physical health (e.g., comorbidities, obesity, poor exercise capacity) contributed to ED presentation/re-presentation, and admission to hospital. Cigarette smoking was associated with hospital admission. Mortality was associated with longer-term oxygen therapy, poor exercise capacity, age, and loss of consciousness. Compliance with clinical guideline recommendations were generally low or mixed. Further, there was a lack of appropriate referral practices upon discharge. Conclusions: While there is considerable literature on factors contributing to AECOPD admission more research is required that investigates the impact that inter-professional care models can have on the discharge planning cycles for patients with COPD who are regular presenters to an ED.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Nursing and Midwifery (1 Jan 2015 - )
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 21 Mar 2022 01:02
Last Modified: 23 Sep 2022 02:17
Uncontrolled Keywords: AECOPD; Chronic obstructive pulmonary disease; Emergency department; Management; Patient outcomes; Scoping review
Fields of Research (2008): 11 Medical and Health Sciences > 1110 Nursing > 111002 Clinical Nursing: Primary (Preventative)
Fields of Research (2020): 42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care
42 HEALTH SCIENCES > 4206 Public health > 420605 Preventative health care
Socio-Economic Objectives (2020): 20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs)
Identification Number or DOI: https://doi.org/10.1016/j.rmed.2022.106747
URI: http://eprints.usq.edu.au/id/eprint/47020

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