title: May smoking be considered as the most important factor that determines premature death after hospitalization due to COPD exacerbation? Preliminary data.
abstract: BACKGROUND
  COPD, cardiovascular diseases and cancer are smoking-related diseases that have been accepted as the leading causes of premature mortality worldwide. Nevertheless, smoking is still considered to be a risk rather than a prognostic factor for mortality. The aim of the study was to determine the most important factors in predicting the risk of premature death after effective hospital treatment of COPD exacerbation.
  
  
  METHODS
  34 consecutive patients hospitalized with COPD exacerbation were followed up and their post-hospitalization survival time was analyzed. Basic clinical data (BORG, MRC, BMI, pack-years and age) was collected. The following tests that were performed prior to discharge were assessed: 6MWT, spirometry, body plethysmography, diffusion capacity, transthoracic echocardiography (TEE) and whole night polysomnography. Routine laboratory and immunoenzymatic tests (hs-CRP, endothelin 1 (ET-1), NT-proBNP, IL-6, TNF-alfa) were analyzed.
  
  
  RESULTS
  The average follow-up period was 15.1 ± 8.2 month. The mortality rate was 3/34 = 8.8%. Univariable analysis revealed significant differences that indicated a greater number of deaths at higher values of: pack-years (p = 0.02), BODE (p = 0.03), heart rate (HR) after 6MWT (p = 0.003), ET-1 (p = 0.04), but at lower values of TLCO/VA (p = 0.03) and 6MWT-distance (p = 0.006). Multivariable analysis revealed that only pack-years (p = 0.005) were predictive for mortality.
  
  
  CONCLUSIONS
  Smoking history seems to have the strongest impact on short-term mortality after recovery from COPD exacerbation.
authors.forename: Szymon
authors.initials: S
authors.lastname: Skoczyński
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mizia-Stec
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Brożek
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Semik-Orzech
authors.forename: Ewa
authors.initials: E
authors.lastname: Sozarńska
authors.forename: Władysław
authors.initials: W
authors.lastname: Pierzchała
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D012307:Risk Factors; D012907:Smoking / Q000401:mortality*; D016896:Treatment Outcome