Cohort Study of Factors Contributing to Mortality Two Months after Exacerbation of COPD According to Patient Destination from Emergency Department
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 5, Issue 2
Abstract
Background: We aimed to determine the mortality two months after exacerbation of chronic obstructive pulmonary disease (eCOPD) and to identify factors associated with mortality, comparing patients admitted to wards and those discharged to home from the emergency department. Methods: This prospective multicentre study included all consecutive patients presenting with eCOPD at emergency departments in 16 public hospitals in Spain. Clinical variables were recorded from a standardized questionnaire. Independent predictors of mortality were modelled by logistic regression analysis. The calibration and discriminative power of the models for the two groups (discharged and admitted) were estimated by the Hosmer-Lemeshow test and the area under the curve (AUC), respectively. Bootstrap methods were applied for internal validation. Results: 2487 patients were included; 1537 (62%) of these were admitted to wards. A total of 155 (6.2%; 95% CI: 5.2% - 7.1%) patients had died at 2 months: mortality was four times higher in patients admitted than in patients discharged. Age ≥ 80 years, Charlson score >2, and pronounced dyspnoea were independent factors for mortality in both groups; in admitted patients, Glasgow scale, baseline treatments for COPD, previous heart disease, complications during hospitalization, and corticoids at discharge were also independent factors. Conclusions: In eCOPD, age, comorbidities, and dyspnoea are important for short-term prognosis in both patients admitted to wards and those discharged to home. In patients admitted to wards, the severity of baseline disease and eCOPD and corticoid treatment affect the short-term prognosis.
Authors and Affiliations
Marisa Baré, Concepción Montón, Xavier Pomares, Juli Font, Núria Torà, Cristina Estirado, José Maria Quintana, Ana Santiago, Silvia Vidal, The IRYSS-COPD Appropriateness Study Group .
Keywords
Related Articles
- EP ID EP348096
- DOI 10.9734/BJMMR/2015/11853
- Views 34
- Downloads 0
The Correlation between Knee Flexion Lower Range of Motion and Osgood-Schlatter's Syndrome among Adolescent Soccer Players
Aims: To evaluate the association between knee flexion range of motion (ROM) and Osgood-Schlatter syndrome among adolescent soccer players. Study Design: Observational case-control study. Methodology: A study group of 20...
Trends of Erectile Dysfunction in Type 2 Diabetic Subjects at a Tertiary Care Unit of Karachi Pakistan
Objective: To compare the occurrence of erectile dysfunction (ED) in male type 2 diabetic subjects with healthy control using IIEF questionnaire at a tertiary care unit of Karachi Pakistan. Methods: It was a single cente...
Prevalence of Anti-HBcore Total and HBsAg among Health Care Workers in Public Hospitals, White Nile State, Sudan; 2013
Background: HBV infection is an occupational disease where health care workers (HCW) are at high risk. Aim: To measure the sero-prevalence of Anti-HBcore Total and HBsAg among HCWs in Public Hospitals, White Nile State,...
Effect of Lighting on Concentration of Medical Students: A Randomised Controlled Trial
Aims: To determine the effect of lighting on concentration in college students. Study Design: Randomised controlled trial. Place and Duration of Study: Melaka-Manipal Medical College (MMMC), Muar Campus, Johor, Malaysia...
Chronic Metal Exposure, Air Pollution and Cancer in Haifa, Israel
Air pollution is a worldwide problem to millions of people exposed to concentrations of air pollutants above safety standards, including fine particulate matter (PM2.5). In Haifa, Israel, the apparent link between pollut...