Hospitalization for a severe exacerbation of COPD (eCOPD) is an important event in the natural history of COPD. Identifying factors related to mortality 1 year after hospitalization could help determine interventions to reduce mortality.
In a prospective, observational, multicentre study, we evaluated data from two cohorts: the Spanish audit of hospital COPD exacerbation care (our derivation sample) and the Spanish cohort of the European audit of COPD exacerbation care (our validation sample). The endpoint was all-cause mortality. Mortality was determined by local research managers of the participating hospitals and matched the official national index records in Spain.
In the multivariate analysis, factors independently related to an increase in mortality were older age, cardio-cerebro-vascular and/or dementia comorbidities, PaCO2 > 55 mmHg measured at emergency department arrival, hospitalizations for COPD exacerbations in the previous year, and hospital characteristics. The area under the receiver-operating curve for this model was 0.75 in the derivation cohort and 0.76 in the validation cohort.
One-year mortality following the index hospitalization for an exacerbation of COPD was related to clinical characteristics of the patient and of the index event, previous events of similar severity, and characteristics of the hospital where the patient was treated.
Puhan MA, Garcia-Aymerich J, Frey M, ter Riet G, Antó JM, Agustí AG, Gómez FP, Rodríguez-Roisín R, Moons KG, Kessels AG, Held U. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index. Lancet. 2009;374:704–11. CrossRefPubMed
Pozo-Rodríguez F, Alvarez CJ, Castro-Acosta A, Melero Moreno C, Capelastegui A, Esteban C, Hernández Carcereny C, López-Campos JL, Izquierdo Alonso JL, López Quílez A, Agustí A, por el Grupo AUDIPOC España. Clinical audit of patients admitted to hospital in Spain due to exacerbation of COPD (AUDIPOC study): method and organisation. Arch Bronconeumol. 2010;46:349–57. CrossRefPubMed
Puhan MA, Hansel NN, Sobradillo P, Enright P, Lange P, Hickson D, Menezes AM, Riet GT, Held U, Domingo-Salvany A, Mosenifar Z, Antó JM, Moons KG, Kessels A, Garcia-Aymerich J, International COPD Cohorts Collaboration Working Group. Large-scale international validation of the ADO index in subjects with COPD: an individual subject data analysis of 10 cohorts. BMJ Open. 2012;2:e002152.
Connors AF Jr, Dawson NV, Thomas C, Harrell FE Jr, Desbiens N, Fulkerson WJ, Kussin P, Bellamy P, Goldman L, Knaus WA. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996;154:959–67. CrossRefPubMed
Connolly MJ, Lowe D, Anstey K, Hosker HS, Pearson MG, Roberts CM, Society BT, the Royal College of Physicians Clinical Effectiveness Evaluation Unit (CEEu). Admissions to hospital with exacerbations of chronic obstructive pulmonary disease: Effect of age related factors and service organisation. Thorax. 2006;61:843–8. CrossRefPubMedPubMedCentral
Cheng Y, Han X, Luo Y, Xu W. Deaths of obstructive lung disease in the Yangpu district of Shanghai from 2003 through 2011: a multiple cause analysis. Chin Med J. 2014;127:1619–25. PubMed
Almagro P, Soriano J, Cabrera F, Boixeda R, Alonso M, Barreiro B, Diez-Manglano J, Murio C, Heredia J, Working Group on COPD, Spanish Society of Internal Medicine. Short- and medium-term prognosis in patients hospitalized for COPD exacerbation: the CODEX index. Chest. 2014;145:972–80. CrossRefPubMed
Price LC, Lowe D, Hosker HS, Anstey K, Pearson MG, Roberts CM, Society BT, the Royal College of Physicians Clinical Effectiveness Evaluation Unit (CEEu). UK National COPD Audit 2003: Impact of hospital resources and organisation of care on patient outcome following admission for acute COPD exacerbation. Thorax. 2006;61:837–42. CrossRefPubMedPubMedCentral
- Predictors of one-year mortality after hospitalization for an exacerbation of COPD
Carlos Jose Alvarez-Martínez
José Luis López-Campos
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II