Peak expiratory flow rate as predictor of inpatient death in patients with chronic obstructive pulmonary disease

South Med J. 2005 Mar;98(3):266-72. doi: 10.1097/01.SMJ.0000152541.89483.AA.


Objectives: Few studies analyze hospital deaths and related factors in patients with acute exacerbation of chronic obstructive pulmonary disease who require hospitalization.

Methods: A cross-sectional study was done with 284 patients who had been admitted consecutively to the Short Stay Medical Unit at the Juan Canalejo Hospital in A Coruña.

Results: Eleven patients (3.9%) died. The independent variables for predicting death were the peak expiratory flow (OR, 0.96; 95% CI, 0.94 to 0.98), long-term oxygen therapy (OR, 12.46; 95% CI, 2.1 to 72.4), and body mass index (OR, 0.73; 95% CI, 0.59 to 0.90). A peak expiratory flow < 150 L/min showed the best specificity and positive predictive value with maximum sensitivity for predicting death. The results of the arterial blood gasses and the functional tests did not predict hospital death.

Conclusions: Peak expiratory flow was the most important predictive value for determining the risk of death in patients who required hospitalization for acute exacerbation of chronic obstructive pulmonary disease. Additional studies are required to validate these findings.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Peak Expiratory Flow Rate
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / etiology
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • ROC Curve
  • Social Class
  • Spain