title: Causes of deaths in COPD patients in primary care setting--a 6-year follow-up.
abstract: BACKGROUND
  COPD is one of the most frequent respiratory diseases responsible for patients' disability and mortality. In 2005 a single primary care practice, COPD was diagnosed in 183 out of 1,960 eligible subjects ≥ 40 years (9.3%). The aim of this study was to assess mortality rate and causes of deaths in this group after 6 years.
  
  
  METHODS
  In 2011 we invited all 183 patients with COPD recognised in 2005. We performed spirometry, physical examination, questionnaire of respiratory symptoms, smoking habits, concomitant diseases and treatment. Information about deaths was taken from primary care register, furthermore, family members were asked to deliver medical documentation or death certificate.
  
  
  RESULTS
  In 2011 we studied only 74 subjects (40.4%), 43 subjects died (23.5%) and 66 subjects were lost from the follow-up (36.1%). Cardiovascular diseases were the most frequent causes of deaths - 21 subjects (48.8%) (heart attack - 8 patients and stroke - 8 patients). Respiratory failure in the course of COPD exacerbation was the cause of 10 deaths (23.3%). Neoplastic diseases lead to 9 deaths (20.9%) (lung cancer 7 patients). Renal insufficiency was responsible for one death (2.325%), and the causes of 2 deaths remained unknown (4.65%). Subjects who died (predominantly males) were older, had higher MRC score and lower FEV₁.
  
  
  CONCLUSIONS
  Study performed six years after COPD diagnosis revealed that 23.5% of subjects died. The main causes of deaths were the following: cardiovascular diseases (mainly heart attack and stroke), COPD exacerbations and lung cancer (more than 75%). Death risk in COPD patients was associated with age, male sex, dyspnoea and severity of the disease.
authors.affiliation: National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland. rp2000m@wp.pl.
authors.forename: Robert
authors.initials: R
authors.lastname: Pływaczewski
authors.forename: Janusz
authors.initials: J
authors.lastname: Maciejewski
authors.forename: Michał
authors.initials: M
authors.lastname: Bednarek
authors.forename: Jan
authors.initials: J
authors.lastname: Zieliński
authors.forename: Dorota
authors.initials: D
authors.lastname: Górecka
authors.forename: Paweł
authors.initials: P
authors.lastname: Śliwiński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D004417:Dyspnea; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000401:mortality; D013147:Spirometry; D020521:Stroke / Q000401:mortality; D011795:Surveys and Questionnaires; D013997:Time Factors