Physiological variables infrequently recorded in acute OPD patients
MedWire News: Many relevant physiological variables are infrequently recorded in patients presenting acutely to hospital with obstructive pulmonary diseases (OPD) and pneumonia, results of a Norwegian study show.
“To our knowledge there is no information on how often physiological variables are measured and recorded in the emergency room (ER), and what distinguishes the recordings in OPD from the ones in pneumonia,” write Amund Gulsvik (University of Bergen) and team.
To investigate, the researchers assessed data on 338 patients (54% women), aged an average of 64 years, admitted to one of three hospitals in western Norway over a 75-day period. In total, 176 patients were diagnosed with OPD (asthma or chronic obstructive pulmonary disease), 103 with pneumonia, and 59 with a combination of OPD and pneumonia.
ER data were obtained on the frequency of recording of respiratory rate, heart rate, peak expiratory flow (PEF), body temperature, cutaneous oxygen saturation, arterial gas concentration (arterial oxygen and carbon dioxide tension), and C-reactive protein (CRP) level.
The researchers found that heart rate, body temperature, and CRP were recorded in most patients, at 99%, 97%, and 91%, respectively. Arterial blood gas concentrations were recorded in 78%, respiratory rate in 66%, PEF in 49%, and cutaneous oxygen saturation in 45% of patients.
Arterial blood gas concentrations were recorded less frequently in patients below the age of 45 years (66%) than in patients aged 65 to 79 years (82%), and most frequently in patients older than 80 years (93%). They were also recorded more frequently in men (84%) than in women (75%).
Measurement of PEF was performed in nearly 68% of patients with OPD and 51% of patients with a combination diagnosis of OPD and pneumonia, but in just 16% of the patients with pneumonia only.
Similarly, respiratory rate was recorded in 74% of patients with OPD, 71% of patients with OPD and pneumonia, but in just 48% of those with pneumonia only.
Peak expiratory flow and respiratory rate were far more frequently recorded in patients admitted to one of the hospitals than in patients admitted to the other two hospitals.
Gulsvik and team conclude: “This study has shown that there is considerable potential for improving the management of patients admitted to hospital with acute pulmonary diseases – in particular, more complete recording of physiological variables in the ER.”
The research is published in the Primary Care Respiratory Journal.
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By Mark Cowen