title: [Clinical profile and treatment of elderly patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease in Spanish Internal Medicine services. ECCO study].
abstract: OBJECTIVE
  Hospitalizations for chronic obstructive pulmonary disease (COPD) occur mostly in elderly patients. We describe the characteristics and treatment of elderly patients hospitalized for COPD in Internal Medicine Services, compared with the younger age group.
  
  
  METHODS
  Observational, prospective, multicenter study. We compared the differences between patients older than 80 years and the rest regarding comorbidity, severity of COPD, previous admissions, length of stay and treatment prescribed. Comorbidity was assessed by the Charlson index and a questionnaire was designed for this purpose.
  
  
  RESULTS
  We included 398 subjects, 353 men (89%) with a mean age of 73.7 years (SD 8.8), of whom about 107 (26.9%) were older than 80 years. These patients had less severe COPD according to the GOLD classification (P<.02). Although the overall morbidity was similar in both groups, elderly patients had greater presence of arrhythmias (P<.01), left ventricular hypertrophy (P<.01) and received more diuretics (P<.05). Dyspnoea, length of stay and mortality were similar between both populations. Home oxygen therapy prior to and use of inhaled corticosteroids and oxygen therapy was lower in older patients, even when they were clinically indicated.
  
  
  CONCLUSIONS
  A quarter of patients hospitalized for COPD in Internal Medicine Services are over 80 years. Although they present less obstruction, they have a similar degree of dyspnea, increased cardiac morbidity and their treatment is less consistent with the recommendations of the guidelines.
authors: Servicio de Medicina Interna, Hospital de Mataró, Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. rboixeda@csdm.cat
authors: Ramon
authors: R
authors: Boixeda
authors: Pedro
authors: P
authors: Almagro
authors: Jesús
authors: J
authors: Díez
authors: Juan
authors: J
authors: Custardoy
authors: Francisco
authors: F
authors: López García
authors: Carlos
authors: C
authors: San Román Terán
authors: Jesús
authors: J
authors: Recio
authors: Joan B
authors: JB
authors: Soriano
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012720:Severity of Illness Index; D013030:Spain; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones