Predictors of all-cause mortality in patients with stable COPD: medical co-morbid conditions or high depressive symptoms.
Co-morbid conditions are frequently found in patients with COPD. We evaluate the association of co-morbidities with mortality, in stable COPD. 224 patients, mean age 61.2 (± 10.00), 48.2% female, mean FEV1 1.1 (± 0.5) liters, median follow-up time 4.2 years, participated. Medical co-morbidities were scored according to the Charlson Co-morbidity Index (CCI). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist-90 (SCL-90). The Cox proportional hazard model was used for survival analyses. In our sample, 70% of all patients have a co-morbid medical condition or high depressive symptoms. During follow-up 51% of all patients died, and those with heart failure have the highest mortality rate (75%). Age, fat-free mass and exercise capacity were predictive factors, contrary to CCI-scores and high depressive symptoms. An unadjusted association between heart failure and survival was found. Although the presence of co-morbidities, using the CCI-score, is not related to survival, heart failure seems to have a detrimental effect on survival. Higher age and lower exercise capacity or fat-free mass predict mortality.
1Department of Health Sciences, Health Psychology Section, University of Groningen, University Medical Center, Groningen , The Netherlands.
Gemma A
GA
Maters
Jacob N
JN
de Voogd
Robbert
R
Sanderman
Johan B
JB
Wempe
D050154:Adiposity; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D015897:Comorbidity; D003863:Depression / Q000401:mortality*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology / Q000523:psychology; D012307:Risk Factors; D015996:Survival Rate
co-morbidity; depression; heart failure; survival