Chest
Clinical InvestigationsCopdMortality After Hospitalization for COPD
Section snippets
Subjects
Between October 1996 and May 1997, we recruited all consecutive patients admitted with COPD exacerbation to any medical ward of Hospital Mútua de Terrassa, a 520-bed, acute-care teaching referral center, in the province of Barcelona, Spain. Inclusion criteria were a clinical diagnosis of COPD, and forced spirometry at discharge showing FEV1 < 70% of the reference value and FEV1/FVC < 70%. Exacerbation was defined as breathlessness, respiratory failure (Po2 < 60 mm Hg and/or Pco2 > 50 mm Hg), or
Results
Of the 141 patients originally evaluated during hospital admission, follow-up information was available for 135 patients (96%; 124 men and 11 women). Six patients (4%) were unavailable for follow-up and were excluded from analysis. Mean age of the population studied was 72.2 ± 9.25 years. The women were older than the men: 79.36 ± 8.96 years vs 71.62 ± 9.03 years (p < 0.007). Mean length of stay was 13.47 ± 9.6 days (range, 2 to 76 days). Seventy patients (58.5%) were in respiratory failure (Po2
Discussion
The purpose of this study was to evaluate mortality predictors after discharge of patients hospitalized for acute exacerbation of COPD. This population consists of aging patients with associated chronic diseases and a high rate of functional dependence. We can expect that the factors predictive of mortality in such patients would be likely to differ from those reported for COPD patients overall. Our study confirms the importance of other factors, namely comorbidity, hospital readmission, the
ACKNOWLEDGMENT
We thank Dr. Pau Sanchez for critical review of the article, and Ms. Mary Ellen Kerans for assistance in writing the article.
References (35)
The impact of COPD on lung health worldwide: epidemiology and incidence
Chest
(2000)- et al.
Predictors of survival in subjects with chronic airflow limitation
Am J Med
(1983) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
Chronic comorbidity and outcomes of hospital care: length of stay, mortality, and readmission at 30 and 365 days
J Clin Epidemiol
(1999) - et al.
Patients readmitted to ICUs: a systematic review of risk factors and outcomes
Chest
(2000) - et al.
Predictors of survival in patients with chronic obstructive pulmonary disease treated with long-term oxygen therapy
Chest
(1991) - et al.
Reversible hypercapnia in chronic obstructive pulmonary disease: a distinct pattern of respiratory failure with a favorable prognosis
Am J Med
(1997) - et al.
Functional status and survival following pulmonary rehabilitation
Chest
(2000) - et al.
Marital status and mortality: the national longitudinal mortality study
Ann Epidemiol
(2000) - et al.
Clinical and personality profiles and survival in patients with COPD
Chest
(1997)
Assessment of ventilatory variables in survival prediction of patients with chronic airflow obstruction: the importance of reversibility
Eur Respir J
Prognosis in chronic obstructive pulmonary disease
Am Rev Respir Dis
Prognosis of patients with chronic obstructive pulmonary disease after hospitalization for acute ventilatory failure: a three year follow-up study
Am Rev Respir Dis
Conservative and respirator treatment of acute respiratory insufficiency in patients with chronic obstructive lung disease
Am Rev Respir Dis
Survival after acute respiratory failure
Ann Intern Med
Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease
JAMA
Outcomes following acute exacerbation of severe chronic obstructive lung disease
Am J Respir Crit Care Med
Cited by (522)
Prognostic value of the five-repetition sit-to-stand test for mortality in people with chronic obstructive pulmonary disease
2022, Annals of Physical and Rehabilitation MedicineCitation Excerpt :Nevertheless, our confirmation of the 5-STS despite different covariates is positive because it reinforces the role of the 5-STS score as an independent prognostic factor. In addition to dyspnoea as a covariate, we included history of heart disease and number of severe exacerbations, which account for one third of COPD-related deaths [17], and the number of severe exacerbations in the previous year, because hospital admissions have a 22% to 43% mortality rate [26,27]. Our study confirmed that this set of covariates was very demanding by the substantial additional percentage of variance explained in each one of the tests; in fact, the other 4 tests examined in our study lost their statistical prognostic value after adjustment.
Difference in survival between COPD patients with an impaired immune reaction versus an adequate immune reaction to seasonal influenza vaccination: The COMIC study
2022, Respiratory MedicineCitation Excerpt :All measurements were performed in stable state. A predefined hazard ratio of 2.0 was assumed and a median survival time of the less immune-competent group of 60 months was estimated based on mortality data of Groenewegen et al. [38] and Almagro et al. [39]. Groenewegen et al. showed that 1 year after hospital admission approximately 22% of patients had died.
Rhinosinusitis without nasal polyps is associated with poorer health-related quality of life in COPD
2021, Respiratory Medicine