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PLoS One. 2012;7(7):e42156. Epub 2012 Jul 31.

Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

Collaborators (592)

Pozo Rodriguez F, Castro Acosta AA, Boukichou Abdelkader NL, Esteban Garcia-Navas S, Pozo Rodríguez F, Agustí A, Álvarez Martínez CJ, Capelastegui Saiz A, Esteban González C, Hernández Carcereny C, Izquierdo Alonso JL, Lopez Campos JL, Melero Moreno C, López Campos JL, Calvo Bonachera J, Falces Sierra A, Soto Campos G, Romero Valero F, Blanco Sáez I, Sánchez Gómez J, Arenas de la Riva M, Cobos Ceballos MJ, Conde Valero A, Vázquez Oliva RV, Hernández Utrera F, Ayerbe García R, Alcázar Navarrete B, Bravo Santervás JM, Fernández Guerra J, Rueda C, Ríos JL, Cabello Rueda FJ, Marín Sánchez F, Pérez Ronchel J, López Campos JL, Alfageme Michavila I, Borderías L, Gascón Pelegrín JM, López A, Torrijos M, Costán Galicia JC, Bello Dronda S, Sánchez Barón A, Gascón Pelegrín JM, Borderías L, Velázquez Benítez A, Julia JG, Cabrera López C, Navarro Esteva J, Alonso M, Pitti R, Batista J, Acosta Fernández O, Gullón JA, Agüero Balbín R, Zabaleta Murguiondo M, Abascal Bolado B, Agüero Balbín R, García Pérez M, Celdran Gil J, Fernández Francés J, Tornero AI, Francisco G, Pedraza F, Verdugo M, Peirón MJ, Fernández Francés J, Izquierdo JL, Orcastegui Candial Toledo JL, Celdrán J, López Gabaldón E, Reyes Hernández Hernández J, Alonso Muñoz JE, Trujillo Santos E, Rodríguez Pascual L, Pascual Pablo E, Camcelo Suárez P, Seco García AJ, Ortiz de Saracho y Bobo J, Fernández Jorge MÁ, Cordovilla Pérez R, Estrada Trigueras G, Orcastegui Candial JL, Disdier C, Macías Fernández E, del Campo Matías F, Fernández García C, Medievilla CA, Domínguez Rodríguez MV, Martínez Rivera C, Monsó Molas E, Soler Porcar N, Hernández C, Rodríguez Lázaro N, Gea J, Pedreny R, Pascual S, Ruiz Mori F, Antón A, Pajares Ruiz V, Pajares Ruiz V, Monsó Molas E, García Olivé I, Rodríguez Fernández E, Lloret Queraltó JA, Palau Benavent M, Celorrio Jiménez N, Haro Estarriol M, Barbé F, Lores Obradors L, Monso E, Esteban L, Ancochea Bermúdez J, Melero Moreno C, Álvarez Martínez CJ, Pérez González V, Rodríguez Trigo G, Zamora García E, González Torralba F, García García R, Gómez Rico F, Steen B, De Higes Martínez E, Izquierdo Patrón M, Ramos Pinedo Á, Jareño J, Granda Uribe I, Campos Téllez S, Rodríguez González Moro Jde M, García J, Jara Chinarro B, Río Ramírez MT, Moreno Zabaleta R, Ramírez Prieto MT, Moreno Arrones BR, García Río F, Alcolea Batres S, Malo de Molina Ruíz R, López Viña A, Ussetti P, Pérez Rodríguez E, Díaz Lobato S, Matesanz Ruíz C, Buendia MJ, Aranda SS, Peces-Barba G, Juretschke Moragues MA, Alonso Viteri S, Álvaro D, Perpina A, Ruíz-Cobos MÁ, Perez de Heredia JH, Cebollero Rivas P, Boldú Mitjans J, Abú-Shams J, Eguía Astibia VM, Pascal Martínez I, Cascante Rodrigo JA, Lorza Blasco JJ, Catalán Serra P, Soler Cataluña JJ, Muñoz A, Querol JM, Chiner Vives E, Andreu Rodríguez A, Pastor E, Miravet L, Marín Royo M, González Villaescusa MC, Catalán Serra P, Soler Cataluña JJ, Fernández Fabrellas E, Cervera Juan Á, Herrerón Silvestre A, Martinez Martínez A, Pellicer Ciscar C, Naval Sendra E, Martínez Moragón E, León Fábregas M, Riesco Miranda JA, Gutierrez Lara JA, Fuentes F, Riesco Miranda JA, Hernández Mezquita MÁ, García Vinuesa G, Fernández Villar A, Suárez Antelo J, Suarez Antelo J, Padin Paz EM, Suarez Martinez J, Paredes Vila S, Golpe Gómez R, Pérez de Llano L, Marcos P, Vilariño Pombo C, García Pazos JM, Baloira A, Fernández Villar A, Represas Represas C, Nuñez Delgado M, Corbacho Abelaira MD, Núñez Fernandez M, García-Cosío B, Laserna Martinez E, Irigaray Canals RM, Pons Vivas S, Garcia Cosio B, Guerrero J, De Astorza A, Cascales García A, Barrón Medrano M, Palacin SC, Barron Medrano M, Ruiz Martínez C, Barron Medrano M, González CE, Carrascosa MI, Tomas L, Arce JA, Celaya MA, Dorronsoro S, Berdejo MR, Rayón M, Garmendia GZ, Royo JI, Palacin SC, Gurrutxaga N, Peña I, Temprano Gogenola M, Dorronsoro S, Estirado C, Sánchez R, Begoña Salinas M, Iturbe I, Antoñana JM, Marin P, Capelastegui A, Esteban C, Egurrola M, Nuñez JM, Camino J, Ruiz Iturriaga LA, Martinez C, García Clemente M, Quero Martínez A, Martínez C, Pascual Pascual T, Díaz Sánchez C, Requejo Mañana B, Del Busto Lorenzo B, Álvarez Navascues F, García Clemente M, Canto Argiz H, Sánchez Nieto JM, Melia Alvarado D, Ros Lucas JA, Castejón Piña N, Andreu Rodríguez AL, Bernabeu Mora R, Sánchez Nieto JM, Alemany Frances ML, Berlinches Acin P, Bernal Belijar I, Orts Arqueros C, Aviles Ingles MJ, Méndez Martinez P, Olmedo Rivas C, Palacios Hidalgo Z, Hurtado Ayuso JE, García Jiménez JM, Cuéllar P, Domenech del Río A, Canales Cid F, Gil Muñoz FL, García Aguilar DJ, Pérez Grimaldi F, Soto Venegas A, Martín Rebollo M, Flores González J, Casado Moreno I, Navarro Pérez V, Rodríguez Martínez V, Núñez Basallote L, Segado Soriano A, Blanco Sáez I, Martínez Cortés MP, García Cuesta A, Pérez Navarro P, Sánchez Barón A, Briz Muñoz H, Anoro Abenoza L, Gómez Rueda B, Cabrera López C, Navarro J, Ramírez P, Acosta O, Cabrera Lacalzada C, Gullón Blanco JA, González LE, Abascal Bolado B, Diago CA, Iglesias Heras M, Francisco G, Cicuendez Trilla R, Tornero AI, Fernández Robledo E, Alfaro Tercero D, Callejas González J, García Castillo S, Verdugo M, Vargas González R, Casado López ME, Peñas Herrero JM, Arnalich Jiménez B, Martínez Martínez A, Hidalgo Carvajal R, García San José I, Quiles Lapuerta J, Nistal Rodríguez A, Sepúlveda MA, Guzmán Robles E, Rodríguez Gallego JP, Fernández Zapata G, Urbano Aranda Y, Cadavid Rodríguez B, Tapias del Pozo JÁ, Budiño Sánchez M, Moreno de Vega Herrero B, Parra Ulloa A, Rodríguez Beltrán E, Hernández Jiménez V, Rodríguez Pascual L, Pérez C, Balledor Adel R, Delgado JL, Pascual de Pablo E, Niso J, Seco García AJ, Fernández Huerga S, Serrano Gutiérrez V, Castrodeza Sanz R, Juárez Moreno E, García IV, Oblanca JC, Iglesias Guerra JA, Albi TR, Pérez RC, González Ruiz JM, Márquez JV, Bernabé Barrios MJ, García García R, Cantera Maortua M, Cepeda Alonso M, Martín Rodríguez S, Ramos Cancelo I, Carrera M, Sánchez P, Ochoa RI, Arribas Jde F, Sánchez Fernández A, Blanco AA, Arroyo A, González San Pedro M, Pajares Mediavilla R, Paredes Arranz C, Pagán Buzo FJ, Arroyo Cozar M, Juarros Martínez S, Arana Ruiz J, Fernández Concellon L, Sánchez Rodríguez JC, Medievilla CA, Fernández García C, Garrote T, Fernández Testa A, Gómez CM, Domínguez Rodríguez MV, Martín-Luquero Ibañez M, García Melón C, Fernández Cdel R, Sanabria J, Peñaloza Á, Fernández Núñez N, Dueñas DV, Carrancio Lomas C, Iglesias Heras M, Seto Gort L, Rubies G, Ribes E, Segura A, Buireu M, Celedón G, Olmeda Arcos ME, Rodríguez González E, Pajares Ruiz V, Antón A, Pedreny R, Talaverano GS, Pradó SV, Melechon ET, Guirado ÁB, Gándara Sanz M, López DL, Portela EB, Hervás R, Salinas E, Muñoz TB, Aguilar Pérez M, Benavides Mañas PD, Alonso AT, Martín C, Segrelles G, Pinedo C, Sanz AH, Kopecna DD, Plasencia MA, Zamarro García C, Gómez del Olmo V, San Cerna AC, Sánchez Mellado D, Wagner Strücvinez C, Gómez Rico F, Moreno Arrones BR, Sanz Cabrera A, Ruzafa Pde A, González Torralba J, Moralejo RA, Llontop C, Martínez Cerón E, Gil Marín B, Izquierdo Patrón M, Ramos Pinedo Á, Martínez Ede H, Pérez Rojo RP, Bilbao-Goyoaga Arenas T, Ruiz-Rico NQ, Trinidad DL, Pelícano S, Fernández J, Gómez García M, Piñeiro Martínez M, Minguez Clemente P, Valle Falcones M, Jiménez BA, Casanova Espinosa Á, Delgado Ede S, Alba P, Somiedo Mdel V, Yamamoto S, García Romero de Tejada JA, Gómez Púnter RM, Ferreira A, Ruiz A, Losada C, Peces EA, Vázquez G, Flores J, Vázquez Mezquita M, Navarrete O, Sánchez S, Gutiérrez Urra T, Hernández Bonaca M, Azcune M, Safont B, Nieto M, Rissi G, Pinel J, Martínez D, Meseguer M, León Fabregas M, Palop Cervera MS, Selfa MJ, Valero I, Martínez A, Peris R, Bonias MA, Pérez VC, Pérez de la Blanca Muñoz C, Rodríguez Mercadal S, Sánchez Sánchez L, Muñoz A, Delgado JG, Pastor E, Gutiérrez Rubio A, Barroso Medel ME, Blázquez Encinar J, Calero Amaro Y, Senent Español C, Camarasa A, Khaled B, Guimera Monserrat J, Bueso Fabra MJ, Aguar Benito MC, Cociu I, Guallar J, Royo JA, Llavador G, Modesto M, Sancho Chust JN, Fernández-Fabrellas E, Santabasilisa A, Herrera S, Lera R, Miralles C, Orosa B, Tortajada IL, Martínez A, Rissi J, Ordoñez Gómez PL, Monclou Garzón EL, Martínez Pitarch MD, Maneu LG, Sanz Cabrera A, Morcillo Lozano B, Marín Torrado JA, Molina Ortiz E, Rodríguez MJ, Serrano Rebollo JC, Díaz Jiménez M, García Ledesma E, Villasaña R, Barroso LC, Badarán E, López Jiménez MJ, García Guisado A, Torres González M, Hernández Mezquita MÁ, Hidalgo Sierra V, Lainez Lazcoz MT, Mariñas Dávila JJ, Rodríguez Martínez G, Padin Paz EM, Suárez Martínez J, Riocabo AM, Álvarez Álvarez A, Golpe Gómez R, Núñez Fernández M, García Pazos JM, Vilariño Pombo C, García Carrero M, Santalla Martínez ML, Tumbeiro Novoa M, Ceresuela Gómez MR, Rodríguez PJ, García GR, Medeiro Domínguez A, González Ayude J, Parente Lamelas I, Botana Rial MI, Leiro Fernández V, Iglesias Río F, Paz AC, Blanquer Escribano D, Cons González MJ, Córdova Díaz R, Astorza Vergara Ád, Escobar Povedano M, Guerrero J, Laserna Martínez E, Tejedor Romera R, Bonilla MV, San Juan F, Fernández Mellado R, Rodríguez Núñez N, Sota Yoldi L, Barreiros M, Cano A, Díaz Sánchez C, Requejo Mañana B, del Busto Lorenzo B, Canto Argiz H, Lombardero Rico E, Villanueva Montes M, Pando Sandoval A, López González FJ, Avilés Inglés MJ, Méndez Martínez P, Rosillo Castro D, Mellado Fernández A, Vallejo Auñon FM, Torre Alvarado JL, Aguayo Jiménez C, Guardiola Martínez J, Alcalde Rumayol C, Paya Peñalver EP, Palazón Fernández D, García Torres P, Castilla Martínez M, Andújar Espinosa R, Birlanga OM, Gálvez Martínez B, Castillo Quintanilla C.

Abstract

BACKGROUNDS:

AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines.

METHODOLOGY/PRINCIPAL FINDINGS:

An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles.

CONCLUSIONS/SIGNIFICANCE:

The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.

PMID:
22911875
PMCID:
PMC3418048
DOI:
10.1371/journal.pone.0042156
[PubMed - indexed for MEDLINE]
Free PMC Article
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