Some 8% of lung disease patients dead within 90 days of previous admission, writes DR MUIRIS HOUSTON
HALF OF all patients admitted to hospital with chronic obstructive pulmonary disease (COPD) in Ireland are either dead or require readmission to hospital within 90 days of their previous admission, a major European research project has found.
The International Comparison of COPD care in Europe report, containing the first audit of care for the chronic lung condition on the Continent, shows that some 8 per cent of patients in the Republic are dead and a further 41 per cent of patients require readmission to hospital within 90 days of their last inpatient stay.
The study of 422 hospitals in 13 countries also found the hospital length of stay here is especially high for women compared with the European average.
COPD is a progressive disease leading to an obstruction to the flow of air in and out of the lungs resulting in difficulty breathing.
It is an umbrella term for two diseases: chronic bronchitis (inflammation and narrowing of the airways) and emphysema (weakening of the structure of the lung).
Essentially, COPD limits the flow of air leading to excess air being trapped in the lungs after a person has breathed out.
A progressive disease most often linked with smoking, it causes chronic breathlessness that can lead to severe disability. More than 400,000 people in Ireland have COPD.
Across Europe, pulmonary rehabilitation programme (PRP) for discharged patients is available in 50 per cent of hospitals.
However, the audit found no examples of home-based PRPs, which compares poorly with countries like Belgium and Switzerland.
Taking part in a PRP improves exercise capacity and quality of life and it reduces both the number of subsequent hospitalisations and the length of admission.
There is a wide variation across Europe in the proportion of patients cared for in specialist respiratory wards; in Ireland it is just 18 per cent compared with Romania and Turkey where some 90 per cent of COPD patients are admitted to specialist units.
Prescribing practices for patients also varied widely; antibiotics and steroids were widely given here, while in Croatia patients were likely to receive intravenous theophylline treatment.
Commenting on the study, Dr Edward McKone, president of the Irish Thoracic Society, said: “Clearly there are areas of COPD care that need improvement but we are encouraged by the progress being made by the national COPD programme, particularly the COPD outreach strategy, which is currently being implemented.