The value of PEF and VAS measurement in the prediction of the severity of the disease and early revisiting rates in patients applying to emergency room due to COPD exacerbation

The purpose of this study is to assess the possible effects of PEF measurement and evaluation of severity of disease by visual analog scale in COPD patients applying to emergency room due to acute exacerbation in the decision of hospitalization or discharge and in the ability to predict the early revisiting rates. The participants were asked to mark the degree of dyspnea on 100 ml visual analog scale (VAS) before starting the treatment (VAS1). Then, their PEF values were measured 3 times by means of PEF-meter and the highest value was recorded as the PEF1 value of the patient. After the treatment, patients were asked again to mark their dyspnea on VAS (VAS2) and then measurements were done by means of PEF-meter 3 times and the highest value was recorded as PEF2. Demographical data, starting and ending vital findings and hospitalization or discharge status of patients were recorded. All patients were called via phone 15 days later and they were interrogated about application to healthcare centers due to the same complaints and their answers were recorded. Statistical analysis was applied to 97 patients in total. 39 of these patients (40,2%) were hospitalized whereas 23 of 58 patients (39,6%) revisited the healthcare centers and 1 patient deceased during treatment in the emergency room. When PEF (PEF1) values of patients that revisited and that didnt were compared, no difference could be found (150-140 p=0,392). In respect of PEF (PEF2) after treatment; while the median values of patients that revisited and that didn?t were found to be 150 and 155 respectively, the difference wasn?t statistically significant (p = 1). The difference between the first VAS (VAS1) values of patients that revisited and that didn?t wasn?t statistically significant (64,9 to 69,9; p=0.359). The VAS (VAS2) average of revisited patients after treatment was found to be 43,6 while this figures was 35,5 in those that didn?t revisit. Consequently the difference wasn?t statistically significant (p = 0.222). PEF1 median of hospitalized patients was 100 while the figure was 150 in discharged patients. The difference between these two values was found to be statistically significant (p = 0.009). PEF2 median of hospitalized and discharged patients was determined to be 125 and 152.5 respectively and the difference was found to be statistically significant (p = 0.019). When the difference between PEF1 and PEF2 values of hospitalized and discharged patients was compared, no statistically significant difference could be found (20 to 12,5; p=0.98). There was no statistically significant difference between VAS1 values of hospitalized and discharged patients ( 68,7 to 66,9; p=0.71 %95 CI: -7,74 to 11,23). When VAS2 values of hospitalized and discharged patients were compared, a statistically significant difference was found ( 49,4 to 38,2; p=0.027 %95 CI:1,25 to 21,14). Even though bedside PEF measurement can deliver information that can be useful in PEF and VAS COPD exacerbation patients, it is not valuable in predicting the revisiting possibility of patients that apply to emergency room due to COPD exacerbation.