Managing patients with COPD exacerbation: does age matter?

Age Ageing. 2012 Jul;41(4):461-8. doi: 10.1093/ageing/afs039. Epub 2012 Mar 27.


Introduction: there is little information about the relationship between age and management of COPD exacerbation (AECOPD), although older persons are known to be at a greater risk of hospital admission.

Methods: we have investigated responses from the clinical and patient questionnaire elements of the 2008 UK COPD audit, splitting the data into age decile.

Results: age ranged from 27 to 102. Patient-reported data suggested older patients had inferior knowledge of COPD, undertook less self-care and were less likely to recognise symptoms of exacerbation prior to hospitalisation. Clinician-reported data showed that although older patients had severe disease and symptoms, greater co-morbidity at presentation and higher mortality, fewer were seen in hospital or followed up subsequently by respiratory specialists. Older patients were more likely to have a DNR order signed within 24 h of admission, irrespective of co-morbidities or performance status. The observations were particularly applicable to those aged 80 or above.

Conclusions: clinicians should consider increasing age as a specific risk factor in the management of COPD. Acute units and community teams should review carefully their protocols and pathways for how they assess, manage, discharge and follow-up older patients with COPD exacerbation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Comorbidity
  • Continuity of Patient Care
  • Disease Progression
  • Female
  • Health Care Surveys
  • Health Services for the Aged* / statistics & numerical data
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Medical Audit
  • Middle Aged
  • Outcome and Process Assessment, Health Care* / statistics & numerical data
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Quality Indicators, Health Care* / statistics & numerical data
  • Referral and Consultation
  • Resuscitation Orders
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United Kingdom