PURPOSE: Recent reports suggest that the mortality rate of chronic obstructive pulmonary disease (COPD) acute exacerbations (AE) achieves a wide range - according to design, cohort selection and period of follow up. Aim: To investigate real life mortality rate of patients (pts) who were first time in the life treated with AE COPD in regional non-university hospital.
METHODS: Retrospective study of all consecutive COPD pts who came to the provincial hospital in rural region (population 130.000) of Czech republic with first AE. All subjects met the ATS/ERS indication criteria for hospitalization. All pts were primarily treated in ward setting (non-ICU) according to current recommendations GOLD and subsequently were monitored regularly in the outpatient clinic at the same hospital.
RESULTS: From Jan 2004 to Dec 2006 was admited 80 subjects with first AE (46 non-infectious and 34 infectious causes) of COPD (mean age 69,8 SD 9,2, 63 men, mean FEV1 47,4%, SD 11,4, mean oxygen saturation 89,3% SD5,2, mean BMI 26,7 SD 5,8). Smokers/ex-smokers/non-smokers(working exposure) ratio was 33/34/13. Most pts (70%)lived in non-urban area. Diagnosis of COPD was made on substrates of post-bronchodilatator spirometry (FEV1/VCmax% bellow LLN). Each of the pts met the AE criteria by Anthoniesen (I. or II.). Within four years 28 (35%) people died (7, 8, 7 and 6 during the 1st,2nd,3rd and 4th year). We observed subsequent risk mortality factors (higher age p=0,0001, lower FEV1 p=0,032, frequent AE p=0,009).
CONCLUSION: We found 35% mortality rate during four year of follow up our AE COPD pts. The main risk factors were elderly age, worsening of lung function and higher frequency of AE, especially during the 1st year.
CLINICAL IMPLICATIONS: Our data demonstrate the seriousness of the AE. Now we continue to expand the file including its extension to urban area.
DISCLOSURE: Vladimir Koblizek, Consultant fee, speaker bureau, advisory committee, etc. Consultant fee, speaker and advisory committee - Boehringer Ingelheim, Pfizer, Glaxo, Novartis, Nycomed, Bayer (in Czech Republic and Austria).; No Product/Research Disclosure Information