SESSION TITLE: COPD Posters
SESSION TYPE: Poster Presentations
PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM
PURPOSE: Our objective has been to assess the survival of a cohort of COPD patients in HO program and to investigate the main causes of mortality between these patients.
METHODS: Retrospective observational study of 311 COPD patients in HO (66,7% men, average age 70,9 ± 9,7 years). Demographic data, pulmonary function tests, comorbid illnesses, concomitant medical treatment and compliance were analyzed. Patients were followed prospectively until December of 2012. A bivariant analysis was made and significant variables (p < 0,1) were introduced in a Cox proportion hazard modeling.
RESULTS: The average time in HO was 4,4 ± 2,7 years and the median survival of 6,9 years (CI 95%: 6,1-7,8). 82,6% of the patients had more than 2 comorbidities (61,4% hypertension, 37,3% diabetes, 50,5% heart disease and 19,6% cancer). At the end of the follow-up mortality was 42,4%. Causes of death were: 54,5% respiratory, 11,4% heart disease and other causes 43,1% (including cancer: 19,7%). Survival at one year, 5 years and 10 years was 95%, 65% and 30%, respectively. Survival rate was significantly higher among younger patients, patients with long-acting-muscarinic (LAMA) use, without previous admissions, with better hematocrit and without cancer, cerebrovascular, renal or urologic disease. In multivariate analysis, mortality remained significantly higher among older patients (OR: 1,05; CI 95%: 1,03-1,07), patients with previous admissions (OR: 1,8; CI 95%: 1,1-3,1), with cancer (OR: 1,7; CI 95%: 1,1-2,6) or renal disease (OR: 2,2; CI 95%:1,5 - 3,2). Patients with cancer had the lowest survival (median: 2 years;CI 95%: 1,4-2,5) while patients with heart disease had the highest (median: 5 years; CI 95%: 2,8-7,1).
CONCLUSIONS: 1.- In our experience, survival of COPD patients in HO was high. 2 - Main causes of mortality were respiratory (54,4%) and oncologic (19,7%). 3.- We found that age, previous admissions, cancer and renal disease were independent predictors of all-cause mortality.
CLINICAL IMPLICATIONS: Advanced COPD patients have a high morbi-mortality. Home Oxygen therapy (HO) improves their prognosis although some studies have found smaller survival in older patients with more comorbid illnesses.
DISCLOSURE: The following authors have nothing to disclose: María del Carmen García García, Jacinto Hernández Borge, Pedro Pires Goncalves, Carlos Antonio Aranda López, Lourdes Cañón Barroso, Estefanía Molina Ortiz, Amparo Sanz Cabrera, José Antonio Gutierrez Lara, María Teresa Gómez Vizcaíno, Ignacio Rodríguez Blanco
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