Causes of Death and Risk Factors for Mortality in Patients With Severe Chronic Obstructive Pulmonary Disease |
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| Authors: | Amalia Moreno Concepción Montón Yolanda Belmonte Miguel Gallego Xavier Pomares Jordi Real |
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| Affiliation: | 1. Servicio de Neumología, Hospital de Sabadell, Corporació Parc Taulí, Sabadell, Barcelona, Spain;2. Servicio de Epidemiología, Unitat de Suport a la Recerca (USR) Lleida, IDIAP Jordi Gol, Lleida, Spain;1. Pneumology Department. Hospital Universitari Vall d’Hebron/Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain;2. Ciber de Enfermedades Respiratorias (CIBERES), Spain;3. Primary Care University Research Institute Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain;4. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain;5. Respiratory Department, Hospital de Alta Resolución de Loja, Granada, Spain;1. Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España;2. Servicio de Neumología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España;3. Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, España;4. Servicio de Neumología, Clínica Universitaria de Navarra, Pamplona, España;5. Unidad de Investigación, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España;6. Pulmonary and Critical Care Service, Brigham and Women''s Hospital, Boston, Massachusetts, Estados Unidos;7. Pulmonary and Critical Care Division, Baystate Medical Center, Springfield, Massachusetts, Estados Unidos;8. Complejo Hospitalario Universitario de Albacete, Albacete, España;1. Department of Respiratory Medicine, Hospital Lucus Augusti, Lugo, Spain;2. Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain;3. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain;4. Department of Respiratory Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain;5. Department of Respiratory Medicine, Hospital de la Santa Creu y Sant Pau, Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain |
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| Abstract: | ObjectiveThe objective of this study was to assess the causes of death and risk factors for mortality in a cohort of patients with severe chronic obstructive pulmonary disease (COPD).Patients and methodsWe studied 203 patients with severe COPD (forced expiratory volume in 1 second [FEV1] <50%), who were attended in our respiratory department day hospital (2001-2006). Clinical variables were recorded on inclusion, and clinical course and causes of death were retrospectively reviewed.ResultsThe mean (SD) age of patients was 69 (8) years and the mean FEV1 was 30.8% (8.2%). One-hundred and nine patients died (53.7%); death was attributed to respiratory causes in 72 (80.9%), with COPD exacerbation being the most frequent specific cause within this category (48.3%). During follow-up, 18.7% required admission to the intensive care unit (ICU). Survival at 1, 3, and 5 years was 80%, 53%, and 26%, respectively. The multivariate analysis showed that mortality was associated with age, stage IV classification according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), cor pulmonale, and hospital admission during the year prior to inclusion. Need for admission to the ICU during follow-up was a factor independently associated with higher mortality.ConclusionsMortality in patients with severe COPD was high and exacerbation of the disease was one of the most frequent causes of death. Age, GOLD stage, cor pulmonale, prior admission to hospital, and need for admission to the ICU during follow-up were independent predictors of mortality. |
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