title: Characteristics and long-term outcome of acute exacerbations in chronic obstructive pulmonary disease: an analysis of cases in the Swedish Intensive Care Registry during 2002-2006.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) represents a major and growing health problem. The purpose of this work was to examine characteristics, resource use and long-term survival in patients with an acute exacerbation of COPD that were admitted to Swedish intensive care units (ICU).
  
  
  METHODS
  Patient characteristics at admission, length of stay (LOS), resource use and outcome were collected for admissions due to COPD during 2002-2006 in the database of the Swedish Intensive Care Registry. Vital status was secured for 99.6% of the patients. Kaplan-Meier survival estimates were computed for index admissions only.
  
  
  RESULTS
  We identified 1009 patients with 1199 admissions due to COPD (1.3% of all intensive care admissions). The mean (SD) age was 70.2 (9.1) years and the proportion of women were 61.5%. Mean (SD) Acute Physiology and Chronic Health Evaluation II probability of hospital death was 0.31 (0.19). Median LOS was 28 (interquartile range 52) h. The number of readmissions was 190 during the 5-year study. Older patients had fewer readmissions (OR 0.96, 95% CI: 0.95-0.98/year increase in age). ICU mortality was 7.3% (87 of 1199 admissions) and 30-day mortality was 26.0% (262 of 1009 index admissions). Median survival was 14.5 months and 31% of patients survived 3 years after the index admission.
  
  
  CONCLUSIONS
  Short (30 days) and long-term survival is poor in acute COPD. Readmissions are frequent reflecting the severity of this chronic illness. Patients are less likely to be readmitted with increasing age which may be due to withholding of further intensive care.
authors.affiliation: Department of Anaesthesia and Intensive Care, Västervik Hospital, Västervik, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Berkius
authors.forename: T
authors.initials: T
authors.lastname: Nolin
authors.forename: C
authors.initials: C
authors.lastname: Mårdh
authors.forename: G
authors.initials: G
authors.lastname: Karlström
authors.forename: S M
authors.initials: SM
authors.lastname: Walther
mesh_terms: D018806:APACHE; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D017741:Survivors; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome