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Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study

PURPOSE: The prevalence of chronic obstructive pulmonary disease (COPD) and comorbidities (eg diabetes and obesity) among Native American (NA) population are higher than among the general US population. However, studies of COPD in NAs are scarce. Oklahoma has the largest NA population affiliated wit...

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Autores principales: Wu, Huimin, Rhoades, Dorothy A, Chen, Sixia, Brown, Brent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089083/
https://www.ncbi.nlm.nih.gov/pubmed/33953553
http://dx.doi.org/10.2147/COPD.S299178
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author Wu, Huimin
Rhoades, Dorothy A
Chen, Sixia
Brown, Brent
author_facet Wu, Huimin
Rhoades, Dorothy A
Chen, Sixia
Brown, Brent
author_sort Wu, Huimin
collection PubMed
description PURPOSE: The prevalence of chronic obstructive pulmonary disease (COPD) and comorbidities (eg diabetes and obesity) among Native American (NA) population are higher than among the general US population. However, studies of COPD in NAs are scarce. Oklahoma has the largest NA population affiliated with federally recognized tribes in the country and is an ideal location for such research. A pilot study was designed to investigate the characteristics of NA patients with COPD exacerbations in a tertiary academic medical center. PATIENTS AND METHODS: We conducted a retrospective exploratory study of NA adults with COPD exacerbation hospitalizations and/or emergency department visits at the University of Oklahoma Medical Center between July 2001 and June 2020. Medical records were reviewed to confirm COPD exacerbation and outcomes, including death, mechanical ventilation, intensive care unit (ICU) stay, home oxygen, and 30-day readmission. Additional collected data included socio-demographics, body mass index, diabetes, other COPD comorbidities and clinical variables. RESULTS: Of 630 encounters reviewed, 159 met the inclusion criteria, representing 91 patients. Most patients were female (64%), obese or overweight (68%), and had diabetes (42%) or hypertension (71%). Mean age was 60 years old, but women were 5 years younger than men. Among the 76 patients with COPD hospitalizations, 31 patients (41%) had an intensive care unit (ICU) stay and 19 (25%) were intubated in their last hospitalization. Among 9 patients (10%) with 30-day readmissions, 8 were female. Medicare, Indian Health Service, Tribal health service, or Medicaid were the most frequently used payment sources. Sex, diabetes, and obesity were not associated with hospital length of stay, 30-day readmission or supplemental O2 use. CONCLUSION: Hospitalized NA COPD patients at this tertiary care center had multiple comorbidities. Many required ICU care and intubation. Larger studies of the risk and mitigating factors for COPD health outcomes in NA patients are needed.
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spelling pubmed-80890832021-05-04 Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study Wu, Huimin Rhoades, Dorothy A Chen, Sixia Brown, Brent Int J Chron Obstruct Pulmon Dis Original Research PURPOSE: The prevalence of chronic obstructive pulmonary disease (COPD) and comorbidities (eg diabetes and obesity) among Native American (NA) population are higher than among the general US population. However, studies of COPD in NAs are scarce. Oklahoma has the largest NA population affiliated with federally recognized tribes in the country and is an ideal location for such research. A pilot study was designed to investigate the characteristics of NA patients with COPD exacerbations in a tertiary academic medical center. PATIENTS AND METHODS: We conducted a retrospective exploratory study of NA adults with COPD exacerbation hospitalizations and/or emergency department visits at the University of Oklahoma Medical Center between July 2001 and June 2020. Medical records were reviewed to confirm COPD exacerbation and outcomes, including death, mechanical ventilation, intensive care unit (ICU) stay, home oxygen, and 30-day readmission. Additional collected data included socio-demographics, body mass index, diabetes, other COPD comorbidities and clinical variables. RESULTS: Of 630 encounters reviewed, 159 met the inclusion criteria, representing 91 patients. Most patients were female (64%), obese or overweight (68%), and had diabetes (42%) or hypertension (71%). Mean age was 60 years old, but women were 5 years younger than men. Among the 76 patients with COPD hospitalizations, 31 patients (41%) had an intensive care unit (ICU) stay and 19 (25%) were intubated in their last hospitalization. Among 9 patients (10%) with 30-day readmissions, 8 were female. Medicare, Indian Health Service, Tribal health service, or Medicaid were the most frequently used payment sources. Sex, diabetes, and obesity were not associated with hospital length of stay, 30-day readmission or supplemental O2 use. CONCLUSION: Hospitalized NA COPD patients at this tertiary care center had multiple comorbidities. Many required ICU care and intubation. Larger studies of the risk and mitigating factors for COPD health outcomes in NA patients are needed. Dove 2021-04-28 /pmc/articles/PMC8089083/ /pubmed/33953553 http://dx.doi.org/10.2147/COPD.S299178 Text en © 2021 Wu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wu, Huimin
Rhoades, Dorothy A
Chen, Sixia
Brown, Brent
Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title_full Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title_fullStr Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title_full_unstemmed Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title_short Native American Patients with Chronic Obstructive Pulmonary Disease Exacerbations in a Tertiary Academic Medical Center – A Pilot Study
title_sort native american patients with chronic obstructive pulmonary disease exacerbations in a tertiary academic medical center – a pilot study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089083/
https://www.ncbi.nlm.nih.gov/pubmed/33953553
http://dx.doi.org/10.2147/COPD.S299178
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