Predictors of one-year mortality after hospitalization for an exacerbation of COPD.

Autor: Esteban C; Pulmonary Service, Galdakao-Usansolo Hospital, Galdakao, Bizkaia, Spain. cristobal.est@gmail.com.; Network and Health Services Research Chronic Diseases (REDISSEC), Bilbao, Bizkaia, Spain. cristobal.est@gmail.com., Castro-Acosta A; Pulmonary Service and Research Institute, Doce de Octubre University Hospital, Madrid, Spain.; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain., Alvarez-Martínez CJ; Pulmonary Service and Research Institute, Doce de Octubre University Hospital, Madrid, Spain.; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain., Capelastegui A; Pulmonary Service, Galdakao-Usansolo Hospital, Galdakao, Bizkaia, Spain., López-Campos JL; Hospital Universitario Virgen del Rocío, Medical- Surgical Unit of Respiratory Diseases, Seville, Spain., Pozo-Rodriguez F; Pulmonary Service and Research Institute, Doce de Octubre University Hospital, Madrid, Spain.; CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2018 Jan 25; Vol. 18 (1), pp. 18. Date of Electronic Publication: 2018 Jan 25.
DOI: 10.1186/s12890-018-0574-z
Abstrakt: Background: Hospitalization for a severe exacerbation of COPD (eCOPD) is an important event in the natural history of COPD. Identifying factors related to mortality 1 year after hospitalization could help determine interventions to reduce mortality.
Methods: In a prospective, observational, multicentre study, we evaluated data from two cohorts: the Spanish audit of hospital COPD exacerbation care (our derivation sample) and the Spanish cohort of the European audit of COPD exacerbation care (our validation sample). The endpoint was all-cause mortality. Mortality was determined by local research managers of the participating hospitals and matched the official national index records in Spain.
Results: In the multivariate analysis, factors independently related to an increase in mortality were older age, cardio-cerebro-vascular and/or dementia comorbidities, PaCO2 > 55 mmHg measured at emergency department arrival, hospitalizations for COPD exacerbations in the previous year, and hospital characteristics. The area under the receiver-operating curve for this model was 0.75 in the derivation cohort and 0.76 in the validation cohort.
Conclusion: One-year mortality following the index hospitalization for an exacerbation of COPD was related to clinical characteristics of the patient and of the index event, previous events of similar severity, and characteristics of the hospital where the patient was treated.
Databáze: MEDLINE
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