0000000000037377
AUTHOR
José Luis López-campos
Determinants of between-hospital variations in outcomes for patients admitted with COPD exacerbations: findings from a nationwide clinical audit (AUDIPOC) in Spain.
Background Previous studies have demonstrated significant variability in the processes of care and outcomes of chronic obstructive pulmonary disease (COPD) exacerbations. The AUDIPOC is a Spanish nationwide clinical audit that identified large between-hospital variations in care and clinical outcomes. Here, we test the hypothesis that these variations can be attributed to either patient characteristics, hospital characteristics and/or the so-called hospital-clustering effect, which indicates that patients with similar characteristics may experience different processes of care and outcomes depending on the hospital to which they are admitted. Methods A clinical audit of 5178 COPD patients co…
Soporte telefónico al paciente con EPOC en tiempos de la COVID-19
Resumen: La imposición del estado de alarma por el Gobierno Español como principal medida para evitar el contagio ha supuesto un cambio en la aproximación clínica al paciente crónico. Aunque las nuevas tecnologías de la comunicación nos ofrecen numerosas formas de establecer un contacto directo, pero en la distancia, las peculiaridades del paciente con EPOC hacen que con frecuencia esta atención sanitaria se vea reducida al teléfono. El reto de atender a los pacientes con EPOC por teléfono supone una complejidad añadida a la atención sanitaria. La entrevista se realizará sin la exploración del paciente, sin nuevas pruebas complementarias y sin poder verificar la técnica inhalatoria. Por tan…
Alpha-1 antitrypsin deficiency: outstanding questions and future directions
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a rare hereditary condition that leads to decreased circulating alpha-1 antitrypsin (AAT) levels, significantly increasing the risk of serious lung and/or liver disease in children and adults, in which some aspects remain unresolved. METHODS: In this review, we summarise and update current knowledge on alpha-1 antitrypsin deficiency in order to identify and discuss areas of controversy and formulate questions that need further research. RESULTS: 1) AATD is a highly underdiagnosed condition. Over 120,000 European individuals are estimated to have severe AATD and more than 90% of them are underdiagnosed. CONCLUSIONS: 2) Several clinical and…
Methodologies for the Determination of Blood Alpha1 Antitrypsin Levels: A Systematic Review
Background: The study of hematic concentrations of alpha1 antitrypsin (AAT) is currently one step in the diagnosis of AAT deficiency. To try to clarify the relevance of the laboratory techniques, we carried out a systematic review of the literature. Methods: Studies evaluating the quantification of AAT in peripheral blood were searched in PubMed in July 2021. The selection criteria included (1) any type of study design that included a quantification of AAT in peripheral blood; (2) studies written in English or Spanish; (3) studies evaluating human beings; and (4) studies involving adults. Results: Out of 207 studies, the most frequently used techniques were nephelometry (43.9%), followed by…
Auditoria clínica de los pacientes hospitalizados por exacerbación de EPOC en España (estudio AUDIPOC): método y organización del trabajo
Antecedentes Existe poca informacion sobre el manejo clinico de pacientes ingresados en hospitales publicos espanoles con un diagnostico de exacerbacion de enfermedad pulmonar obstructiva cronica. AUDIPOC es una auditoria clinica sobre el manejo de exacerbacion de EPOC en Espana. Objetivos Validar la adecuacion y validez de los instrumentos de medicion de las variables propuestas en AUDIPOC Espana (estudio preliminar) y verificar su viabilidad en un medio complejo con hospitales de tamano, recursos y organizacion diferentes (estudio piloto). Material y metodos El estudio preliminar se realizo en 4 hospitales y 213 casos. El estudio piloto en 30 hospitales de 6 comunidades autonomas y 1.203 …
[Clinical audit of patients admitted to hospital in Spain due to exacerbation of COPD (AUDIPOC study): method and organisation].
There is little information regarding the clinical management of hospital inpatients diagnosed with exacerbation of Chronic Obstructive Pulmonary Disease (COPD). AUDIPOC is a clinical audit dealing with the clinical management of COPD in Spain.To examine the adequacy and validity of the instruments used to measure the variables proposed by AUDIPOC Spain (Preliminary Study) and to verify the viability of AUDIPOC in a complex environment with hospitals of different sizes, resources, and organizational layout (Pilot Study).The Preliminary Study took place in 4 hospitals and studied 213 cases. The Pilot Study took place in 30 hospitals of 6 Autonomous Communities (i.e. Regions) and studied 1203…