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P430 Treatment characteristics of hospitalized patients with chronic obstructive pulmonary disease (COPD): differences according to length of stay
s152
Abstracts
I European
Journal
of Internal
a 6-week period were scrutinised. Staff admitting these patients were asked to complete an awareness questionnaire. Results: Initially only 2% of RFA forms were completed. After implementing changes, a second audit showed that 34% were completed. In the recent audit, the notes of 106 patients admitted to MAU were examined. Of these, 21 (20%) had the RFA form filled in, and 85 (80%) had incomplete RFA forms. Out of these 85 patients, 20 (24%) warranted thromboprophylaxis. This was not being administered at the time of the audit. Conclusion; Our audits suggest that few patients are assessed for thromboembolic risk even in a unit where proactive measures have been introduced. The questionnaire review shows that the level of background knowledge about thromboembolic disease is generally low. This suggests that clinical staff must be educated regularly about the benefits of thromboprophlaxis. Most of responders to the questionnaire felt that nursing staff should complete the RFA form, and that incorporation of the RFA into the admission documentation should be considered. We have recently implemented 6 monthly refresher courses for all doctors admitting patients to the MAU, and look forwards to repeating the audit to assess any potential improvement.
of group
Sl -S1.59
P431 Non convulsive status epilepticus (NCSE) in elderly patients with acute neurological alterations P. Young, F. Bottaro, B. Finn, J. Adamson, 0. Martinez, M.M. Fernandez Pardal, R. Reisin, J. Bruetman (Buenos Aires, AR)
Introduction; Our aim was to evaluate some treatment characteristics of our COPD patients and specifically look for differences between patients discharge before the fifth day and those extending their hospital stay. Methods: Retrospective review of treatment charts through our data-
characteristics
14 (2003)
base in the Pharmacy Unit (our system of computerised prescription allows an easy analysis), of all patients with the main diagnosis of COPD admitted. Comparison between patients with a <5 days stay (group 1) and those with a hospital stay >5 days (group 2). Study period: 24 months. Results: We analysed a total of 137 patients with the main diagnosis of COPD with 84% males in group 1 and 91% in group 2. Mean age was 71.87 and 72.94 years and mean stay 3.31 and 5.62 days for groups 1 and 2 respectively. Mean number of drugs per day during admittance was 11 and 14 for group 1 and 2 respectively. Anti-microbial treatment characteristics are shown in Tables 1 and 2. Mean anti-microbial expenditure per patient was 3.75 - (0.64 VO and 3.11 IV) and 5.39 - (0.79 VO and 4.6 IV) for groups 1 and 2 respectively. Steroid use characteristics are shown in Table 3. Discussion: In a simultaneous work we have evidenced how difficult it is to predict length of hospital stay in COPD patients. Some differences in antibiotic and steroid prescription habits are evident between groups. Not surprisingly, we found a significant increase in IV anti-microbial expenditures between groups and no differences in the oral route. Although treatment characteristics during admittance are clearly different in these subsets of patients, they do not allow prediction of outcome because most of this data can only be obtained after discharge. Computerised inhospital prescription is a useful tool research for these type of studies and should counterbalance the prejudice of some doctors towards its use.
P430 Treatment characteristics of hospitalized patients with chronic ohstructive pulmonary disease (COPD): differences according to length of stay F. Hidalgo, M. Bonilla, R. Rodriguez Rosado, F. Rond6n, S. Plaza, D. Ferreiro, B. Garcia, J. Marco (Madrid, E)
Table 1 Anti-microbial
Medicine
Background;
NCSE
is a common
under-recognized
cause of neurological
1
Anti-microbial
Route
Units
MG
cost
MG/patient
Cost/patient
Amoxicilline-clavulanate Amoxicilline-clavulanate Ceftriaxone Ciprofloxacin Ciprofloxacin Clarithromycin Clarithromycin Levofloxacin Levofloxacin
IV vo IV IV vo IV vo IV vo
207 115 11 2 16 2 66 2 9
215000 99500 12000 400 8000 1000 33000 1000 4500
528.4 36.9 39.4 4.4 4.1 23.8 73.0 59.7 25.2
3115.9 1442.0 173.9 5.7 115.9 14.4 478.2 14.4 65.2
7.65 0.53 0.57 0.06 0.06 0.34 1.05 0.86 0.36
Table 2 Anti-microbial
characteristics
of group
2
Anti-microbial
Route
Units
MG
cost (El
MG/patient
Cost /patient (E)
Amoxicilline-clavulanate Amoxicilline-clavulanate Ceftriaxone Ciprofloxacin Ciprofloxacin Clarithromycin Claritbromycin Levofloxacin Levofloxacin
IV vo IV IV vo IV vo IV vo
353 224 26 14 32 14 91 9 24
353000 192625 38000 2800 16000 7000 45500 4500 12000
877.6 72.1 113.9 54.35 16.9 167.2 100.4 269.0 65.8
5191.1 2832.7 558.8 41.1 235.2 102.9 669.1 66.1 176.4
12.90 1.06 1.67 0.79 0.24 2.45 1.47 3.95 0.96
Abstracts
I European
Journal
of Internal
a 6-week period were scrutinised. Staff admitting these patients were asked to complete an awareness questionnaire. Results: Initially only 2% of RFA forms were completed. After implementing changes, a second audit showed that 34% were completed. In the recent audit, the notes of 106 patients admitted to MAU were examined. Of these, 21 (20%) had the RFA form filled in, and 85 (80%) had incomplete RFA forms. Out of these 85 patients, 20 (24%) warranted thromboprophylaxis. This was not being administered at the time of the audit. Conclusion; Our audits suggest that few patients are assessed for thromboembolic risk even in a unit where proactive measures have been introduced. The questionnaire review shows that the level of background knowledge about thromboembolic disease is generally low. This suggests that clinical staff must be educated regularly about the benefits of thromboprophlaxis. Most of responders to the questionnaire felt that nursing staff should complete the RFA form, and that incorporation of the RFA into the admission documentation should be considered. We have recently implemented 6 monthly refresher courses for all doctors admitting patients to the MAU, and look forwards to repeating the audit to assess any potential improvement.
of group
Sl -S1.59
P431 Non convulsive status epilepticus (NCSE) in elderly patients with acute neurological alterations P. Young, F. Bottaro, B. Finn, J. Adamson, 0. Martinez, M.M. Fernandez Pardal, R. Reisin, J. Bruetman (Buenos Aires, AR)
Introduction; Our aim was to evaluate some treatment characteristics of our COPD patients and specifically look for differences between patients discharge before the fifth day and those extending their hospital stay. Methods: Retrospective review of treatment charts through our data-
characteristics
14 (2003)
base in the Pharmacy Unit (our system of computerised prescription allows an easy analysis), of all patients with the main diagnosis of COPD admitted. Comparison between patients with a <5 days stay (group 1) and those with a hospital stay >5 days (group 2). Study period: 24 months. Results: We analysed a total of 137 patients with the main diagnosis of COPD with 84% males in group 1 and 91% in group 2. Mean age was 71.87 and 72.94 years and mean stay 3.31 and 5.62 days for groups 1 and 2 respectively. Mean number of drugs per day during admittance was 11 and 14 for group 1 and 2 respectively. Anti-microbial treatment characteristics are shown in Tables 1 and 2. Mean anti-microbial expenditure per patient was 3.75 - (0.64 VO and 3.11 IV) and 5.39 - (0.79 VO and 4.6 IV) for groups 1 and 2 respectively. Steroid use characteristics are shown in Table 3. Discussion: In a simultaneous work we have evidenced how difficult it is to predict length of hospital stay in COPD patients. Some differences in antibiotic and steroid prescription habits are evident between groups. Not surprisingly, we found a significant increase in IV anti-microbial expenditures between groups and no differences in the oral route. Although treatment characteristics during admittance are clearly different in these subsets of patients, they do not allow prediction of outcome because most of this data can only be obtained after discharge. Computerised inhospital prescription is a useful tool research for these type of studies and should counterbalance the prejudice of some doctors towards its use.
P430 Treatment characteristics of hospitalized patients with chronic ohstructive pulmonary disease (COPD): differences according to length of stay F. Hidalgo, M. Bonilla, R. Rodriguez Rosado, F. Rond6n, S. Plaza, D. Ferreiro, B. Garcia, J. Marco (Madrid, E)
Table 1 Anti-microbial
Medicine
Background;
NCSE
is a common
under-recognized
cause of neurological
1
Anti-microbial
Route
Units
MG
cost
MG/patient
Cost/patient
Amoxicilline-clavulanate Amoxicilline-clavulanate Ceftriaxone Ciprofloxacin Ciprofloxacin Clarithromycin Clarithromycin Levofloxacin Levofloxacin
IV vo IV IV vo IV vo IV vo
207 115 11 2 16 2 66 2 9
215000 99500 12000 400 8000 1000 33000 1000 4500
528.4 36.9 39.4 4.4 4.1 23.8 73.0 59.7 25.2
3115.9 1442.0 173.9 5.7 115.9 14.4 478.2 14.4 65.2
7.65 0.53 0.57 0.06 0.06 0.34 1.05 0.86 0.36
Table 2 Anti-microbial
characteristics
of group
2
Anti-microbial
Route
Units
MG
cost (El
MG/patient
Cost /patient (E)
Amoxicilline-clavulanate Amoxicilline-clavulanate Ceftriaxone Ciprofloxacin Ciprofloxacin Clarithromycin Claritbromycin Levofloxacin Levofloxacin
IV vo IV IV vo IV vo IV vo
353 224 26 14 32 14 91 9 24
353000 192625 38000 2800 16000 7000 45500 4500 12000
877.6 72.1 113.9 54.35 16.9 167.2 100.4 269.0 65.8
5191.1 2832.7 558.8 41.1 235.2 102.9 669.1 66.1 176.4
12.90 1.06 1.67 0.79 0.24 2.45 1.47 3.95 0.96