Tuberc Respir Dis.  2006 Feb;60(2):205-214.

Predictors of Long-term Mortality after Hospitalization for Acute Exacerbation of COPD

• Jung HS
• Lee JH
• Chun EM
• Moon JW
• Chang JH

Abstract

BACKGROUND: Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD.
METHODS
We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded.
RESULTS
Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean FEV1 was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality.
CONCLUSION
Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.

Keyword

COPD; Mortality determinants; Heart rate; Right ventricular systolic pressure

MeSH Terms

Blood Pressure
Bronchiectasis
Cicatrix
Cohort Studies
Follow-Up Studies
Heart Rate
Hospitalization*
Humans
Mortality*
Pulmonary Disease, Chronic Obstructive*
Radiography
Retrospective Studies
Thorax
Tuberculosis

Figure

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  Figure 1 Study design. EWUH, Ewha Womans University Hospital.

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  Figure 2 Survival curve during follow-up for the presence or absence of tachycardia in stable state of COPD.

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  Figure 3 Survival curve during follow-up for different levels of right ventricular systolic pressure (RVSP) measured using echocardiography.

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