The impact on severe exacerbations of establishing a cross-sectorial lung team for patients with COPD at high risk of exacerbating: a pilot study

Figures & data

Figure 1. Patient flowchart

Table 1. Characteristics of patients (n = 49)

Variables
Age (years) range Mean (SD)	45–90 71.7 (8.6)
Lung function (FEV1 in % predicted) range* Mean (SD)	16–73 34.5 (12.7)
n (%)
Gender Female	31 (63.3)
Marital status Married/cohabitant	23 (46.9)
Residence Private home Nursing home	47 (95.9) 2 (4.1)
Rehabilitation Attended rehabilitation	20 (40.8)
Home oxygen LTOT	19 (38.8)
Smoking status Active smoker Ex-smoker Never smoker	11 (22.5) 37 (75.5) 1 (2.0)

* one missing value; SD, standard deviation; LTOT, long-term oxygen therapy.

Table 2. Means before and after the intervention for the eight subscales in CAT (n = 49)

	Mean ‘Before’	Mean ‘After’	P-value Difference between ‘Before’ and ‘After’
Cough	2.37	2.22	0.736
Phlegm	2.86	2.47	0.024
Chest tightness	1.33	1.20	0.378
Breathlessness	4.47	4.12	0.072
Activity	3.51	3.59	0.697
Confidence	2.08	1.96	0.992
Sleep	1.88	1.88	0.854
Energy	3.47	3.41	0.887

Table 3. Differences in total CAT score before and after the intervention

	n	Mean	Range	SD	95% CI	P-value
Before	49	21.96	12–31	4.90	20.55; 23.37
After	49	20.86	4–32	5.88	19.17; 22.55
Difference	49	1.10	−9 – 24	6.29	−0.71; 2.91	0.226

SD, standard deviation; 95%CI, 95% confidence interval.

Figure 2. Total CAT score before and after the intervention

Table 4. Observed and predicted numbers of admissions and length of hospital stay per patient

	Period: February to August
	2013 Observed	2014 observed	2015 observed	2016 predicted	2016 Intervention observed
Hospital admissions (mean per patient)
COPD	0.3	0.5	0.7	1.2	0.7
Other cause	0.2	0.3	0.4	0.4	0.5
COPD + comorbidity	0.1	0.1	0.2	0.2	0.1
All causes (total)	0.6	1.3	1.3	2.1	1.2
Hospital days (mean per patient)
COPD	1.1	2.4	4.6	9.3	3.8
Other cause	1.0	1.4	1.6	2.2	1.6
COPD + comorbidity	0.6	1.0	2.7	6.1	0.6
All causes (total)	2.6	4.8	8.9	16.4	6.0

Figure 3. Number of admissions and mean length of stay in days per admission

Observed admissions and length of stayPredicted admissions and length of stayObserved admissions and length of stay during intervention.

Table 5. Number of observed admissions and length of hospitalizations versus predicted for 2016

Poisson regression repeated measurement 2016 observed versus 2016 predicted (period February to August
	Estimate	Exponentiated (estimate)	Exponentiated LCL*	Exponentiated UCL**	P-value
Hospital admissions
COPD	−0.61	0.54	0.32	0.90	0.0192
Other cause	0.25	1.28	0.62	2.61	0.5019
COPD + comorbidity	−0.59	0.56	0.18	1.73	0.3104
All causes (total)	−0.53	0.59	0.40	0.86	0.0064
Length of stay
COPD	−0.88	0.41	0.22	0.76	0.0046
Other cause	−0.33	0.72	0.29	1.77	0.4696
COPD + comorbidity	−2.33	0.10	0.03	0.29	0.0001
All causes (total)	−1.01	0.36	0.22	0.61	0.0001

* LCL, Lower control limit; ** UCL, Upper control limit.