Mortality After Hospitalization for COPD

Chest. 2002 May;121(5):1441-8. doi: 10.1378/chest.121.5.1441.

Abstract

Objectives: To identify variables associated with mortality in patients admitted to the hospital for acute exacerbation of COPD.

Design: Prospective cohort study.

Setting: Acute-care hospital in Barcelona (Spain).

Patients: One hundred thirty-five consecutive patients hospitalized for acute exacerbation of COPD, between October 1996 and May 1997.

Measurements and results: Clinical, spirometric, and gasometric variables were evaluated at the time of inclusion in the study. Socioeconomic characteristics, comorbidity, dyspnea, functional status, depression, and quality of life were analyzed. Mortality at 180 days, 1 year, and 2 years was 13.4%, 22%, and 35.6%, respectively. Sixty-four patients (47.4%) were dead at the end of the study (median follow-up duration, 838 days). Greater mortality was observed in the bivariate analysis among the oldest patients (p < 0.0001), women (p < 0.01), and unmarried patients (p < 0.002). Hospital admission during the previous year (p < 0.001), functional dependence (Katz index) [p < 0.0004], greater comorbidity (Charlson index) [p < 0.0006], depression (Yesavage Scale) [p < 0.00001]), quality of life (St. George's Respiratory Questionnaire [SGRQ]) [p < 0.01], and PCO(2) at discharge (p < 0.03) were also among the significant predictors of mortality. In the multivariate analysis, the activity SGRQ subscale (p < 0.001; odds ratio [OR], 2.62; confidence interval [CI], 1.43 to 4.78), comorbidity (p < 0.005; OR, 2.2; CI, 1.26 to 3.84), depression (p < 0.004; OR, 3.6; CI, 1.5 to 8.65), hospital readmission (p < 0.03; OR, 1.85; CI, 1.26 to 3.84), and marital status (p < 0.0002; OR, 3.12; CI, 1.73 to 5.63) were independent predictors of mortality.

Conclusions: Quality of life, marital status, depressive symptoms, comorbidity, and prior hospital admission provide relevant information of prognosis in this group of COPD patients.

MeSH terms

  • Acute Disease
  • Aged
  • Carbon Dioxide / blood
  • Comorbidity
  • Confidence Intervals
  • Depression / complications
  • Dyspnea / etiology
  • Female
  • Forced Expiratory Volume
  • Hospitalization*
  • Humans
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Oxygen / blood
  • Prognosis
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Quality of Life
  • Risk Factors
  • Socioeconomic Factors
  • Spain / epidemiology
  • Surveys and Questionnaires
  • Survival Rate
  • Vital Capacity

Substances

  • Carbon Dioxide
  • Oxygen