Mortality after hospitalization for COPD.
OBJECTIVE
To identify variables associated with mortality in patients admitted to the hospital for acute exacerbation of COPD.


METHODS
Prospective cohort study.


METHODS
Acute-care hospital in Barcelona (Spain).


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


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.
Almagro
Pedro
P
Internal Medicine, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain. 19908pam@comb.es
Calbo
Esther
E
Ochoa de Echagüen
Anna
A
Barreiro
Bienvenido
B
Quintana
Salvador
S
Heredia
José L
JL
Garau
Javier
J
D000208:Acute Disease; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D015897:Comorbidity; D016001:Confidence Intervals; D003863:Depression / Q000150:complications; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014797:Vital Capacity
D002245:Carbon Dioxide; D010100:Oxygen