TY - JOUR T1 - Social and clinical predictors associated with prolonged hospital stays for patients with severe exacerbation of chronic obstructive pulmonary disease JO - Revista Clínica Española (English Edition) T2 - AU - Fernández-García,S. AU - Represas-Represas,C. AU - Ruano-Raviña,A. AU - Botana-Rial,M. AU - Mouronte-Roibas,C. AU - Ramos-Hernández,C. AU - Fernández Villar,A. SN - 22548874 M3 - 10.1016/j.rceng.2019.05.002 DO - 10.1016/j.rceng.2019.05.002 UR - https://www.revclinesp.es/en-social-clinical-predictors-associated-with-articulo-S2254887419301304 AB - ObjectiveTo determine whether there are social factors that affect the prolonged hospital stay (PHS) of patients with severe chronic obstructive pulmonary disease exacerbation (COPDE), as well as clinical–demographic factors. MethodologyWe conducted a prospective cohort study that consecutively included patients who were admitted to a Pneumology department for COPDE. We recorded demographic, clinical (tobacco use, exacerbations and infections, dyspnea, impact according to CAT questionnaire, pulmonary function, comorbidities, oxygen therapy and noninvasive ventilation) and social (financial status, caregiver availability and overload, dependence for basic and instrumental activities, social risk and use of social services) variables, employing questionnaires and indices such as Barthel, Lawton-Brody, Zarit, Barber and Gijón. We performed a univariate and multivariate analysis using a logistic regression model. ResultsThe study included 253 patients, with a mean age of 68.9±9.8 years; 77.1% of whom were men. The logistic regression model included active tobacco use, FEV1 value, CAT score>10, dyspnea 3–4 on the MMRC, the presence of bacteria in sputum cultures, cardiovascular comorbidity, anemia, home oxygen therapy, living alone, rural residence, caregiver overload and detecting social–family risks/problems. The variables independently associated with the possibility of PHS were a CAT score>10 (OR, 8.9; p=.04) and detecting a social–family risk/problem (OR, 2.6; p=.04). Active smoking was a predictor of shorter stays (OR, 0.15; p=.002). ConclusionsVariables related to the social sphere play a relevant role in hospital stays, as do the impact of the disease and the persistent use of tobacco by patients with severe COPD exacerbation. ER -