LAUSR

Severe exacerbations of chronic obstructive pulmonary disease (COPD) are associated with fatal outcomes, especially in patients in need of hospitalizations. Repeated hospitalizations increase the economic burden of COPD. Objective: identification of the risk factors for repeated hospital admissions of patients with COPD, assessing the possibility of their modification. Methods: a retrospective analysis of case records of all patients admitted in the city hospital with exacerbations of COPD during 18 calendar months (161), of which 118 patients were hospitalized once, 14 - twice, and 5 - three times. Results: During inpatient treatment defects of therapy were detected: bronchodilator therapy (excessive theophylline), antimicrobial therapy and oxygen therapy (noncompliance, insufficient control of effects). Inhalation steroids were recommended excessively, with increasing frequency after each subsequent discharge. There was no control of adherence to treatment in outpatient settings. Significant risk factors for repeated hospitalizations were identified: male sex (RR 2,29; 95% CI; 0,78-6,69), age >70 years (RR 2,069; 95% CI; 1,01-4,2), smoking experience >40 years (RR 5,3; 95% CI; 1,6-17,5), duration of COPD >6 years (RR 2,4; 95% CI; 0,98-6,18), the presence of three or more concomitant diseases, first of all, cardiovascular (RR 13,0; 95% CI; 1,89-90,14). Conclusions: to reduce the risk of repeated hospitalizations, the main emphasis of treatment and prophylaxis should be directed to patients of working age: early smoking cessation, adequate treatment of COPD exacerbations and comorbidity in the hospital, control of adherence to treatment after discharge.