Predictors of mortality after hospitalisation for acute exacerbation of chronic obstructive pulmonary disease

Introduction: In this study we wanted to identify predictors of mortality among patients hospitalised for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Materials and methods: 596 patients hospitalised for AECOPD were retrospectively studied after discharge from Oslo University Hospital, Aker between 2006 and 2008 with median follow-up time 30 months (range 0 to 56)). The patients' characteristics and potential predictors of death at the index admission were abstracted from medical records. Hazard ratios for death were estimated using multivariate Cox regression among those with valid spirometry. Results: Mean age was 73 years (SD 11), 54% were women. In total 112 patients received non-invasive ventilation (NIV) during the index admission. Mean forced expiratory volume in one second (FEV 1 ) was 43% of predicted (SD 17), mean body mass index (BMI) was 24 kg/m 2 (SD 6). In total, 303 patients (51%) died. Hazard ratios for death of each predictor are listed in Table 1. Table 1. Predictors of mortality following hospitalisation for AECOPD (N=426) Hazard ratio 95,0% CI P-value Upper Lower Age, increase of 1 year 1,06 1,04 1,08 <0,001 Sex, female vs. male 0,74 0,55 1,00 0,048 No comorbidity (referent) 1 of 12 comorbidities 1.16 0.77 1.75 0.484 2 of 12 comorbidities 1.27 0.81 1.98 0.301 ≥3 of 12 comorbidities 1,80 1,15 2,82 0,01 NIV 1,73 1,19 2,52 0,004 FEV1(% pred), increase of 10% 0,88 0,79 0,97 0,014 BMI, increase of 1 kg/m 2 0,95 0,92 0,98 0,003 Conclusion: High age, male sex, more than two comorbidities, need for non-invasive ventilation, low FEV 1 and low BMI were associated with increased mortality after hospitalisation for AECOPD.