title: In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a frequent cause of hospitalization in the United States. Previous studies of selected populations of patients with COPD have estimated in-hospital mortality to range from 4% to 30%. Our objective was to obtain a generalizable estimate of in-hospital mortality from acute exacerbation of COPD in the United States and to identify predictors of in-hospital mortality using administrative data.
  
  
  METHODS
  We performed a cross-sectional study utilizing the 1996 Nationwide Inpatient Sample, a data set of all hospitalizations from a 20% sample of nonfederal US hospitals. The study population included 71 130 patients aged 40 years or older with an acute exacerbation of COPD at hospital discharge. The primary outcome assessed was in-hospital mortality.
  
  
  RESULTS
  In-hospital mortality for patients with an acute exacerbation of COPD was 2.5%. Multivariable analyses identified older age, male sex, higher income, nonroutine admission sources, and more comorbid conditions as independent risk factors for in-hospital mortality.
  
  
  CONCLUSIONS
  Mortality during hospitalization in this nationwide sample of patients with acute exacerbations of COPD was lower than that of previous studies of select populations. This estimate should provide optimism to both clinicians and patients regarding prognoses from COPD exacerbations requiring hospitalization. Our results indicate that the use of administrative data can help to identify subsets of patients with acute exacerbations of COPD that are at higher risk of in-hospital mortality.
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E Monument Street, Suite 7110 A, Baltimore, MD 21205, USA.
authors.forename: Susheel P
authors.initials: SP
authors.lastname: Patil
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.forename: Noah
authors.initials: N
authors.lastname: Lechtzin
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Diette
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D017722:Hospital Charges; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology