A comparative study of the effect of clinical practice guideline for management acute exacerbation in chronic obstructive pulmonary disease patients on acute respiratory failure and length of stay in Phukieochalermprakiat Hospital, Chaiyaphum Province

Background : Chronic Obstructive Pulmonary Disease ( COPD ) is still remains a leading cause of high morbidity and mortality. Goal of treatment are decrease symptom and prevent future risks ( prevention and treatment of acute exacerbation, complication) Objective : To compare the effect of clinical practice guideline for management acute exacerbation in chronic obstructive pulmonary disease patients at Phukieochalermprakiat Hospital, Chaiyaphum Province Method and material : The research is a retrospective study that compare the percentage of acute respiratory failure , length of stay before(the data were collected from  1 January 2561 – 31 December 2561) and after (the date collected from 1 January 2562 – 31 December 2562) usage of the clinical practice guideline for management acute exacerbation in chronic obstructive pulmonary disease patients  in Phukieochalermprakiat Hospital, Chaiyaphum Province.The data was retrieved from the medical records including age, gender, precipitating factor, treatment, length of stay and acute respiratory failure. Result :  The hospitalized COPD patients with acute exacerbation in this study were 64 cases (109 admissions) before using the clinical practice guideline and 64 cases (99 admissions) after using guideline. The most precipitating factor of acute exacerbation is respiratory tract infection.  The average length of stay before and after using guideline are 3.3 ± 3.39 days , 1.97 ± 0.92day  ( p < 0.001) in consequently. The percentage of  acute respiratory failure is not different between both groups 1.4% (no clinical practice) vs 1% (clinical practice guideline) (P = 0.739). In addition, the 28-day readmission rate is decrease from 7.2% to 2.9% ( p  = 0.069 ). Conclusion : Treatment of COPD with acute exacerbation with antibiotics is impact on length of stay but not impact on acute respiratory failure.