Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts.
BACKGROUND
The aim of this study was to describe the management and prognosis related to a hospital admission for acute exacerbation of chronic obstructive pulmonary disease and to compare results to an earlier study.


OBJECTIVE
This is a retrospective study of 300 consecutively discharged patients admitted in 2006-2007 with an exacerbation of chronic obstructive pulmonary disease from three respiratory departments. Data were collected from patient charts and compared with a replicate study done in 2001.


RESULTS
The mean age was 72.1years; 61.7% were women. Mean forced expiratory volume in 1s was 37.6% of predicted. On admission, 11.3% were treated with non-invasive ventilation, and 84.3% were given systemic corticosteroids. In-hospital mortality was 4.7%. At discharge, treatment with inhaled corticosteroids or at least one long-acting bronchodilator was given to 86.7% and 89% of patients, respectively, which was significantly higher than for similarly sampled patients in 2001. Mortality in 30days and 1year after discharge was 4.5% and 25.5%, respectively, compared with 5.5% and 30.3% in 2001, the 12-month mortality being significantly lower (P=0.03). Readmission rate in the 12months following discharge was 42.3%. Long-term oxygen treatment, treatment with anti-dysrhythmic drugs and lack of outpatient follow-up were independent predictors of 1-year mortality. Risk of readmission was increased with dependence in self-care activities, previous admissions and treatment with strong analgesics.


CONCLUSIONS
Over a period of 6years, a significantly higher number of patients are being treated according to guidelines. Survival following discharge increased over the same period.
Eriksen
Nanna
N
Department of Cardiology and Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark. nannae@ofir.dk
Vestbo
Jørgen
J
D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors