Comorbidity, Hospitalization, and Mortality in COPD: Results from a Longitudinal Study

Autor: Corrado De Vito, Daniela Ceccarelli, Salvatore Mariotta, Angelo Petroianni, Claudio Terzano, Elda Graziani, Antonio Vitarelli, Fabio Di Stefano, Vittoria Conti, Giovanni Puglisi, Paolo Villari, Luigi Allegra, Alberto Ricci
Rok vydání: 2010
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Heart Diseases
Exacerbation
Comorbidity
Disease
Pulmonary function testing
Pulmonary Disease
Chronic Obstructive
Pulmonary Heart Disease
hospitalization
chronic obstructive pulmonary disease comorbidity hospitalization long-term prognosis mortality
comorbidity
mortality
chronic obstructive pulmonary disease
long-term prognosis
Risk Factors
Forced Expiratory Volume
Internal medicine
Diabetes mellitus
Diabetes Mellitus
Humans
Medicine
Longitudinal Studies
Prospective Studies
Prospective cohort study
Intensive care medicine
Aged
COPD
business.industry
Smoking
Respiratory disease
Carbon Dioxide
Middle Aged
Prognosis
medicine.disease
respiratory tract diseases
Hospitalization
Oxygen
Residual Volume
Hypertension
Kidney Failure
Chronic
Female
Pulmonary Ventilation
business
Zdroj: Lung. 188:321-329
ISSN: 1432-1750
0341-2040
DOI: 10.1007/s00408-009-9222-y
Popis: We evaluated comorbidity, hospitalization, and mortality in chronic obstructive pulmonary disease (COPD), with special attention to risk factors for frequent hospitalizations (more than three during the follow-up period), and prognostic factors for death. Two hundred eighty-eight consecutive COPD patients admitted to respiratory medicine wards in four hospitals for acute exacerbation were enrolled from 1999 to 2000 in a prospective longitudinal study, and followed up until December 2007. The Charlson index without age was used to quantify comorbidity. Clinical and biochemical parameters and pulmonary function data were evaluated as potential predictive factors of mortality and hospitalization. FEV(1), RV, PaO(2), and PaCO(2) were used to develop an index of respiratory functional impairment (REFI index). Hypertension was the most common comorbidity (64.2%), followed by chronic renal failure (26.3%), diabetes mellitus (25.3%), and cardiac diseases (22.1%). Main causes of hospitalization were exacerbation of COPD (41.2%) and cardiovascular disease (34.4%). Most of the 56 deaths (19.4%) were due to cardiovascular disease (67.8%). Mortality risk depended on age, current smoking, FEV(1), PaO(2), the REFI index, the presence of cor pulmonale, ischemic heart disease, and lung cancer. Number and length of hospital admissions depended on the degree of dyspnea and REFI index. The correct management of respiratory disease and the implementation of aggressive strategies to prevent or treat comorbidities are necessary for better care of COPD patients.
Databáze: OpenAIRE
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