title: Mortality in COPD patients discharged from hospital: the role of treatment and co-morbidity.
abstract: BACKGROUND
  The aim of this study was to analyse mortality and associated risk factors, with special emphasis on health status, medications and co-morbidity, in patients with chronic obstructive pulmonary disease (COPD) that had been hospitalized for acute exacerbation.
  
  
  METHODS
  This prospective study included 416 patients from each of the five Nordic countries that were followed for 24 months. The St. George's Respiratory Questionnaire (SGRQ) was administered. Information on treatment and co-morbidity was obtained.
  
  
  RESULTS
  During the follow-up 122 (29.3%) of the 416 patients died. Patients with diabetes had an increased mortality rate [HR = 2.25 (1.28-3.95)]. Other risk factors were advanced age, low FEV1 and lower health status. Patients treated with inhaled corticosteroids and/or long-acting beta-2-agonists had a lower risk of death than patients using neither of these types of treatment.
  
  
  CONCLUSIONS
  Mortality was high after COPD admission, with older age, decreased lung function, lower health status and diabetes the most important risk factors. Treatment with inhaled corticosteroids and long-acting bronchodilators may be associated with lower mortality in patients with COPD.
authors.affiliation: Department of Respiratory Medicine, Allergy and Sleep, Landspitali-University Hospital, Reykjavik, Iceland. ggudmund@landspitali.is
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gudmundsson
authors.forename: Thorarinn
authors.initials: T
authors.lastname: Gislason
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.forename: Runa
authors.initials: R
authors.lastname: Hallin
authors.forename: Charlotte Suppli
authors.initials: CS
authors.lastname: Ulrik
authors.forename: Eva
authors.initials: E
authors.lastname: Brøndum
authors.forename: Markku M
authors.initials: MM
authors.lastname: Nieminen
authors.forename: Tiina
authors.initials: T
authors.lastname: Aine
authors.forename: Per
authors.initials: P
authors.lastname: Bakke
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000401:mortality*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000628:therapy*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate