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Predictors of long-term survival in elderly patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease.
Respirology. 2008 Nov; 13(6):851-5.R

Abstract

BACKGROUND AND OBJECTIVE

There is a paucity of survival data regarding the prognosis of elderly patients following acute exacerbations of COPD (AECOPD). We undertook a study to examine long-term mortality rates and to identify clinical and laboratory predictors of these outcomes.

METHODS

A retrospective cohort study was conducted of 786 consecutive elderly (>65 years) patients admitted to general medicine acute-care wards for AECOPD. Factors determining short- and long-term mortality were analysed.

RESULTS

The mean (+/-SD) age of the study population was 75.8 +/- 7.3 years (range 65-100 years). The in-hospital mortality rate for the entire cohort was 7.25%. The risk of mortality at 1, 3 and 5 years was 28%, 47% and 54%, respectively. In univariate analysis age (hazard ratio 1.52; 95% confidence interval: 1.23-1.91), FEV(1) (1.45; 1.73-2.35), active cancer (1.23; 1.64-2.32), current smoking (1.74; 1.35-2.11), ischaemic heart disease (1.58; 1.28-2.02), congestive heart failure (1.55; 1.23-2.26) and maintenance use of oral glucocorticosteroids (1.58; 1.11-2.79) were significantly associated with mortality. In multivariate analysis, only current smoking (1.89; 1.18-1.93), ischaemic heart disease (1.41; 1.07-1.68), PaCO(2) on admission (1.49; 1.03-1.60), hospital readmission (2.23; 1.40-2.18) and FEV(1) (1.41; 1.12-1.54) were independent predictors of mortality.

CONCLUSIONS

This study provides new insights into the predictive factors associated with long-term prognosis in elderly patients admitted for acute exacerbations of COPD, which differ from those previously identified for younger patients.

Authors+Show Affiliations

Pulmonary Division, Rambam Health Care Campus and The Bruce Rappaport School of Medicine, Haifa, Israel. o_fruchter@rambam.health.gov.ilNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18811883

Citation

Fruchter, Oren, and Mordechai Yigla. "Predictors of Long-term Survival in Elderly Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease." Respirology (Carlton, Vic.), vol. 13, no. 6, 2008, pp. 851-5.
Fruchter O, Yigla M. Predictors of long-term survival in elderly patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Respirology. 2008;13(6):851-5.
Fruchter, O., & Yigla, M. (2008). Predictors of long-term survival in elderly patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Respirology (Carlton, Vic.), 13(6), 851-5. https://doi.org/10.1111/j.1440-1843.2008.01367.x
Fruchter O, Yigla M. Predictors of Long-term Survival in Elderly Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Respirology. 2008;13(6):851-5. PubMed PMID: 18811883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of long-term survival in elderly patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. AU - Fruchter,Oren, AU - Yigla,Mordechai, PY - 2008/9/25/pubmed PY - 2009/2/4/medline PY - 2008/9/25/entrez SP - 851 EP - 5 JF - Respirology (Carlton, Vic.) JO - Respirology VL - 13 IS - 6 N2 - BACKGROUND AND OBJECTIVE: There is a paucity of survival data regarding the prognosis of elderly patients following acute exacerbations of COPD (AECOPD). We undertook a study to examine long-term mortality rates and to identify clinical and laboratory predictors of these outcomes. METHODS: A retrospective cohort study was conducted of 786 consecutive elderly (>65 years) patients admitted to general medicine acute-care wards for AECOPD. Factors determining short- and long-term mortality were analysed. RESULTS: The mean (+/-SD) age of the study population was 75.8 +/- 7.3 years (range 65-100 years). The in-hospital mortality rate for the entire cohort was 7.25%. The risk of mortality at 1, 3 and 5 years was 28%, 47% and 54%, respectively. In univariate analysis age (hazard ratio 1.52; 95% confidence interval: 1.23-1.91), FEV(1) (1.45; 1.73-2.35), active cancer (1.23; 1.64-2.32), current smoking (1.74; 1.35-2.11), ischaemic heart disease (1.58; 1.28-2.02), congestive heart failure (1.55; 1.23-2.26) and maintenance use of oral glucocorticosteroids (1.58; 1.11-2.79) were significantly associated with mortality. In multivariate analysis, only current smoking (1.89; 1.18-1.93), ischaemic heart disease (1.41; 1.07-1.68), PaCO(2) on admission (1.49; 1.03-1.60), hospital readmission (2.23; 1.40-2.18) and FEV(1) (1.41; 1.12-1.54) were independent predictors of mortality. CONCLUSIONS: This study provides new insights into the predictive factors associated with long-term prognosis in elderly patients admitted for acute exacerbations of COPD, which differ from those previously identified for younger patients. SN - 1440-1843 UR - https://www.unboundmedicine.com/medline/citation/18811883/Predictors_of_long_term_survival_in_elderly_patients_hospitalized_for_acute_exacerbations_of_chronic_obstructive_pulmonary_disease_ L2 - https://doi.org/10.1111/j.1440-1843.2008.01367.x DB - PRIME DP - Unbound Medicine ER -