PURPOSE: Hospitalizations, and their sequelae, comprise key morbidities in the natural history of chronic obstructive pulmonary disease (COPD). We analyzed data from participants from two longitudinal cohorts (Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study) to determine the association between the GOLD stage of COPD and mortality.
METHODS: We limited our analysis to 20,503 of 21,680 participants with complete baseline data (demographics, lung function and smoking history). We stratified subjects, based on their prebronchodilator lung function, according to modified GOLD criteria, including a “restrictive” category (FEV1/FVC >70% and FVC < 80%). We defined “severe COPD exacerbations” as at least one hospitalization with a diagnosis of COPD (ICD-9 codes 490–496) within five years of the baseline visit. Outcomes were death within 5 years of baseline and death within the entire follow-up period (mean of 9.9 years).
RESULTS: Presented in Table.
CONCLUSION: Increasing COPD severity (GOLD stage) was associated with a higher rate of severe exacerbations (hospitalizations), although exacerbations at any stage led to higher risk of short-term and long-term mortality.
CLINICAL IMPLICATIONS: COPD hospitalizations occur even in patients with mild impairment and result in increased risk of all-cause mortality.
DISCLOSURE: David Mannino, University grant monies None; Grant monies (from sources other than industry) None; Grant monies (from industry related sources) D. Mannino - GSK, Pfizer, Novartis; Shareholder None; Employee K Davis - GSKD Miller - GSK; Fiduciary position (of any organization, association, society, etc, other than ACCP D Mannino - COPD Foundation, USCOPD Coalition; Consultant fee, speaker bureau, advisory committee, etc. D Mannino - GSK, Pfizer, BI, Astra-Zeneca, Dey, Sepracor; Other None; No Product/Research Disclosure Information