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Clinical Investigations: COPD |

Mortality After Hospitalization for COPD*

Pedro Almagro, MD; Esther Calbo, MD; Anna Ochoa de Echagüen, MD; Bienvenido Barreiro, MD; Salvador Quintana, MD; José L. Heredia, MD; Javier Garau, MD
Author and Funding Information

*From the Internal Medicine (Drs. Almagro, Calbo, Ochoa de Echagüen, and Garau), Respiratory (Drs. Heredia and Barreiro), and Intensive Care Unit (Dr. Quintana) Services, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain.

Correspondence to: Pedro Almagro, MD, Department of Medicine, Hospital Mútua de Terrassa, Pl Dr Robert, 5. Terrassa 08221 Barcelona, Spain; e-mail: 19908pam@comb.es



Chest. 2002;121(5):1441-1448. doi:10.1378/chest.121.5.1441
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Published online

Objectives: To identify variables associated with mortality in patients admitted to the hospital for acute exacerbation of COPD.

Design: Prospective cohort study.

Setting: Acute-care hospital in Barcelona (Spain).

Patients: One hundred thirty-five consecutive patients hospitalized for acute exacerbation of COPD, between October 1996 and May 1997.

Measurements and results: Clinical, spirometric, and gasometric variables were evaluated at the time of inclusion in the study. Socioeconomic characteristics, comorbidity, dyspnea, functional status, depression, and quality of life were analyzed. Mortality at 180 days, 1 year, and 2 years was 13.4%, 22%, and 35.6%, respectively. Sixty-four patients (47.4%) were dead at the end of the study (median follow-up duration, 838 days). Greater mortality was observed in the bivariate analysis among the oldest patients (p < 0.0001), women (p < 0.01), and unmarried patients (p < 0.002). Hospital admission during the previous year (p < 0.001), functional dependence (Katz index) [p < 0.0004], greater comorbidity (Charlson index) [p < 0.0006], depression (Yesavage Scale) [p < 0.00001]), quality of life (St. George’s Respiratory Questionnaire [SGRQ]) [p < 0.01], and Pco2 at discharge (p < 0.03) were also among the significant predictors of mortality. In the multivariate analysis, the activity SGRQ subscale (p < 0.001; odds ratio [OR], 2.62; confidence interval [CI], 1.43 to 4.78), comorbidity (p < 0.005; OR, 2.2; CI, 1.26 to 3.84), depression (p < 0.004; OR, 3.6; CI, 1.5 to 8.65), hospital readmission (p < 0.03; OR, 1.85; CI, 1.26 to 3.84), and marital status (p < 0.0002; OR, 3.12; CI, 1.73 to 5.63) were independent predictors of mortality.

Conclusions: Quality of life, marital status, depressive symptoms, comorbidity, and prior hospital admission provide relevant information of prognosis in this group of COPD patients.

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