COPD in Colorectal and Other Bowel Surgery Patients Increases Risk of ICU Stay By as Much as 32% in Wisconsin Hospitals


In Chronic Obstructive Pulmonary Disease (COPD)

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By: James Pitt  May. 09, 2018

Chronic obstructive pulmonary disease (COPD) is a lung disease involving reduced airflow. According to the Centers for Disease Control, COPD was the third-leading cause of death in the US in 2014. The main cause is long-term exposure to lung irritants. Dexur has covered COPD heavily, including the US hospitals with shortest length of stay.

COPD commonly occurs alongside one or more other conditions. In fact, patients with COPD have a higher risk of comorbidities than controls. A 2013 review listed:

Patients with COPD in addition to other conditions have increased mortality risk, along with worse health status and disability. To examine how COPD affects patient outcomes, Dexur analysts used CMS discharge data to examine 2013-2016 ICU stays among patients with and without COPD among patients at hospitals in Wisconsin.

For all comorbidities examined, patients with COPD were more likely to have an ICU stay than patients without COPD. The strongest effect was in DRG 329, Major Small And Large Bowel Procedures With Major Complication Or Comorbidity.

Here, Dexur analysts used odds ratios to summarize the relationship between COPD and ICU stays in DRG 329 patients. At Froedtert Hospital, the odds that a DRG 329 patient with COPD would have an ICU stay were 4.03 times the odds that a DRG 329 patient without COPD would have an ICU stay.

Previous research has found a link between COPD and increased length of stay (LOS) in colorectal surgery patients. Kelly et. al 2012 found that COPD increased median LOS by at least a week. Schmelzer et. al 2008 found that patients with COPD were more likely to have greater-than-median LOS than patients without (3.1 odds ratio). Programs like enhanced recovery after surgery (ERAS) may help reduce length of stay in colorectal surgery patients.

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  1. Total Discharges, Total Chronic Obstructive Pulmonary Disease Discharges, Percentage of discharges with ICU Stay, Percentage of discharges with ICU Stay (Without Chronic Obstructive Pulmonary Disease), Percentage of discharges with ICU Stay (With Chronic Obstructive Pulmonary Disease), Odds of COPD if ICU stay, Odds of COPD if no ICU stay, and Odds ratio of COPD with vs without ICU stay for DRG 329 patients at Froedtert Hospital (Milwaukee), University of Wisconsin Hospital (Madison), SSM Health St Mary’s Hospital (Madison), Mayo Clinical Hospital - Eau Claire Hospital (Eau Claire), and Aurora St. Luke’s Medical Center (Milwaukee) from January 2013 to December 2016.

ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.