One-year and long-term mortality in patients hospitalized for chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Identifying potentially-modifiable predictors of mortality could help optimize COPD patient management. The aim of this study is to determine long-term mortality following hospitalization due to acute exacerbations of COPD (AECOPD), as well as AECOPD mortality predictors. Methods: We conducted a retrospective study by reviewing the medical records of all patients admitted with AECOPD in the University Hospital Complex of Santiago de Compostela in 2007 and 2008. In order to identify variables independently associated with mortality, we conducted a multivariate Cox proportional hazard regression analysis including those variables which proved to be significant in the univariate analysis. Results: Seven hundred and fifty seven patients were assessed. Patient mean age was 74.8 years and males accounted for 77% of all patients. Mean stay was 12.2 days. Three point six percent of all patients required intensive care. As for mortality rates, 1-year mortality was 26.2%, and 5-year mortality was 64.3%. In both scenarios, the most frequent causes of death were respiratory and cardiovascular disorders. Factors independently associated with mortality were older age, hospitalization by internal medicine (IMU), length of stay, the need for mechanical ventilation (MV) or noninvasive mechanical ventilation (NIV), early readmission, and history of atrial fibrillation (AF) and dementia. Conclusions: In patients with COPD, age, exacerbation severity and comorbidity have long-term prognostic significance.