2011 OPEN FORUM Abstracts
PERFORMANCE OF ACTIVITIES OF DAILY LIVING AS A PREDICTOR OF REHOSPITALIZATION FOR PATIENTS WITH COPD EXACERBATIONS.
Brian W. Carlin1, Dan Easley2, Kim Wiles2, Nan Rees3; 1Allegheny General Hospital, Pittsburgh, PA; 2Klingensmith HealthCare, Ford City, PA; 3St. Clair Hospital, Pittsburgh, PA
Background: A significant number of patients with COPD who are hospitalized with an exacerbation are readmitted to the hospital within a 30 day period following discharge. Predictors for such rehospitalization risk have yet to be identified. Purpose: To evaluate the rehospitalization rates for patients with COPD using performance of activities of daily living as a metric marker. Method: The Discharge, Assessment, and Summary at Home (D.A.S.H., Klingensmith HealthCare, Ford City, Pennsylvania) program is a respiratory therapist driven home care based program for patients with COPD who are using supplemental oxygen following discharge from the hospital. As part of the program the measurement of activities of daily living is made on the day #1, day #7, and day #30 post-hospitalization. A series of four patient selected ADLs is performed at each visit (e.g walking the four points of the home, loading the dishwasher). Oxygen saturations are maintained above 90% using a SmartDose Oxygen delivery system. Each ADL is performed and measured as either completed or not completed based upon the actual task at hand. Results: A total of 229 patients were entered into the study and had four ADLs performed at each of the three visits. 23/229 (9%) patients were readmitted to the hospital within a 30 day period. 8 (3.5%) were readmitted with a COPD exacerbation and the remaining 15 (6.6%) were readmitted for other reasons. For those patients (n=42) who performed 1 or less of 4 ADLs to completion by day #7 of the program, there were 8 (19%) readmitted. For those patients who could perform 2 or more ADLs to completion there were 15/187 (8%) readmitted. Conclusions: Those patients with COPD who were oxygen dependent following hospital discharge for an exacerbation who could perform one or less ADLs to completion by 7 days following discharge have a higher 30 day readmission rate to the hospital. Performance of ADLs may be a helpful marker to determine risk for rehospitalization and should be considered to be performed in the home environment following discharge.
Sponsored Research - Klingensmith Staff members performed the ADL measurements and data collection.