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Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease.
Age Ageing 2005; 34(5):491-6AA

Abstract

INTRODUCTION

acute exacerbation of COPD (AECOPD) is a major cause of hospital admission, and predicts subsequent medium-term mortality. We aimed to examine mortality predictors in patients discharged from hospital after AECOPD.

METHODS

we obtained baseline demographic and clinical data from 100 patients (mean age (range)=73 (60-98) years; 48 males) admitted with AECOPD. All completed the following validated questionnaires: a quality of life questionnaire (Breathing Problems Questionnaire; BPQ); a screening questionnaire for depression (Brief Assessment Schedule Depression Cards; BASDEC); a disability questionnaire (Manchester Respiratory Activities of Daily Living questionnaire; MRADL). Following discharge all were prospectively followed and survival/mortality at 12 months confirmed from hospital notes and by contacting general practitioners.

RESULTS

the prevalence of depression at recruitment was 56%. One-year mortality in the whole group was 36%. Odds ratios (95% confidence intervals) for mortality predictors (univariate logistic regression analysis) were: use of long-term oxygen therapy=2.72 (1.06-6.97); subsequent readmission=2.57 (1.08-6.12); MRADL score=0.87 (0.80-0.94) (disability predicting death); BASDEC score=1.13 (1.02-1.26) (depression predicting death); BPQ score=1.08 (1.04-1.12) (low quality of life predicting death); length of original hospital stay=1.03 (1.00-1.07). On multivariate logistic regression analysis the only mortality predictor was BPQ with an odds ratio (95% confidence limits) of 1.13 (1.04-1.22). In terms of mortality prediction for individuals, a threshold MRADL score of <12 gave a sensitivity of 86%, specificity of 55%, positive predictive value of 88% and negative predictive value of 52%, with similar predictive values using BPQ as an independent variable.

CONCLUSIONS

1-year mortality after AECOPD admission is high. The presence of depressive illness (which is extremely common), and levels of both disability and impairment of quality of life are univariate predictors of 1-year mortality in this patient group. This model may be useful in predicting prognosis for individuals and thus in guiding treatment decisions.

Authors+Show Affiliations

Metropolitan University of Manchester, Manchester School of Physiotherapy, Manchester, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16107452

Citation

Yohannes, Abebaw M., et al. "Predictors of 1-year Mortality in Patients Discharged From Hospital Following Acute Exacerbation of Chronic Obstructive Pulmonary Disease." Age and Ageing, vol. 34, no. 5, 2005, pp. 491-6.
Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age Ageing. 2005;34(5):491-6.
Yohannes, A. M., Baldwin, R. C., & Connolly, M. J. (2005). Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age and Ageing, 34(5), pp. 491-6.
Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year Mortality in Patients Discharged From Hospital Following Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Age Ageing. 2005;34(5):491-6. PubMed PMID: 16107452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. AU - Yohannes,Abebaw M, AU - Baldwin,Robert C, AU - Connolly,Martin J, PY - 2005/8/19/pubmed PY - 2006/1/4/medline PY - 2005/8/19/entrez SP - 491 EP - 6 JF - Age and ageing JO - Age Ageing VL - 34 IS - 5 N2 - INTRODUCTION: acute exacerbation of COPD (AECOPD) is a major cause of hospital admission, and predicts subsequent medium-term mortality. We aimed to examine mortality predictors in patients discharged from hospital after AECOPD. METHODS: we obtained baseline demographic and clinical data from 100 patients (mean age (range)=73 (60-98) years; 48 males) admitted with AECOPD. All completed the following validated questionnaires: a quality of life questionnaire (Breathing Problems Questionnaire; BPQ); a screening questionnaire for depression (Brief Assessment Schedule Depression Cards; BASDEC); a disability questionnaire (Manchester Respiratory Activities of Daily Living questionnaire; MRADL). Following discharge all were prospectively followed and survival/mortality at 12 months confirmed from hospital notes and by contacting general practitioners. RESULTS: the prevalence of depression at recruitment was 56%. One-year mortality in the whole group was 36%. Odds ratios (95% confidence intervals) for mortality predictors (univariate logistic regression analysis) were: use of long-term oxygen therapy=2.72 (1.06-6.97); subsequent readmission=2.57 (1.08-6.12); MRADL score=0.87 (0.80-0.94) (disability predicting death); BASDEC score=1.13 (1.02-1.26) (depression predicting death); BPQ score=1.08 (1.04-1.12) (low quality of life predicting death); length of original hospital stay=1.03 (1.00-1.07). On multivariate logistic regression analysis the only mortality predictor was BPQ with an odds ratio (95% confidence limits) of 1.13 (1.04-1.22). In terms of mortality prediction for individuals, a threshold MRADL score of <12 gave a sensitivity of 86%, specificity of 55%, positive predictive value of 88% and negative predictive value of 52%, with similar predictive values using BPQ as an independent variable. CONCLUSIONS: 1-year mortality after AECOPD admission is high. The presence of depressive illness (which is extremely common), and levels of both disability and impairment of quality of life are univariate predictors of 1-year mortality in this patient group. This model may be useful in predicting prognosis for individuals and thus in guiding treatment decisions. SN - 0002-0729 UR - https://www.unboundmedicine.com/medline/citation/16107452/Predictors_of_1_year_mortality_in_patients_discharged_from_hospital_following_acute_exacerbation_of_chronic_obstructive_pulmonary_disease_ L2 - https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afi163 DB - PRIME DP - Unbound Medicine ER -