Comorbidities and short-term prognosis in patients hospitalized for acute exacerbation of COPD. The ESMI study.
Chest. 2012 Apr 5;
Authors: Almagro P, Cabrera FJ, Diez J, Boixeda R, Ortiz B, Murio C, Soriano JB,
Abstract: BACKGROUND:Comorbidities are frequent in patients hospitalized for COPD exacerbation, but little is known about their relation with short-term mortality and hospital readmissions. Our hypothesis is that the frequency and type of comorbidities impair the prognosis within 12 weeks after discharge. MATERIAL AND METHODS:A longitudinal, observational, multicenter study of patients hospitalized for a COPD exacerbation with spirometric confirmation was performed. Comorbidity information was collected using the Charlson index and a questionnaire that included other common conditions not included in this index. Dyspnea, functional status, and previous hospitalization for COPD or other reasons among other variables were investigated. Information on mortality and readmissions for COPD or other causes was collected up to 3 months after discharge. RESULTS:We studied 606 patients, 594 men (89.9%), with a mean (SD) age of 72.6 (9.9) years and a post-bronchodilator FEV1 of 43.2 % (21.2). The mean Charlson index score was 3.1 (2.0). On admission, 63.4% of patients had arterial hypertension, 35.8% diabetes mellitus, 32.8% chronic heart failure, 20.8% ischemic heart disease, 19.3% anemia and 34% dislipemia. Twenty-seven patients (4.5%) died within 3 months. The Charlson index was an independent predictor of mortality (p<0.003; O.R.1.23; C.I. 95%: 1.07-1.40), even after adjustment for age, FEV1 and functional status measured with the Katz index. Comorbidity was also related with the need for hospitalization from the emergency room, length of stay, and hospital readmissions for COPD or other causes. CONCLUSIONS:Comorbidities are common in patients hospitalized for a COPD exacerbation, and they are related with short-term prognosis.
PMID: 22490870 [PubMed - as supplied by publisher]