What question did this study set out to answer?

To evaluate the prevalence of prognostic indicators for predicting end of life in COPD patients admitted to a nurse-led unit.

March 14, 2026

End of life in COPD: There may be no surprises!

Puntos clave

To evaluate the prevalence of prognostic indicators for predicting end of life in COPD patients admitted to a nurse-led unit.
Collected data on general and COPD-specific prognostic indicators from August 2010 to January 2011.
Applied the surprise question to assess clinician perceptions of patient mortality risk.
Included 199 patients with a mean age of 70 years.
48% of patients had clinicians who would not be surprised if they died within 6-12 months.
87% of patients had at least one prognostic indicator identified upon admission.
14 out of 15 patients who died had a negative response to the surprise question and at least one other prognostic indicator present.

Resumen

Background: In the UK prognostic indicators have been developed for predicting end of life (EOL) in COPD. We report on the prevalence of these indicators in patients admitted to a nurse led unit for people with acute exacerbations of COPD (AECOPD). Methods: Data on general and COPD specific prognostic indicators plus the surprise question were collected on all admissions Aug 2010 to Jan 2011. Results: Total 199 patients (54%F). Mean age 70 (37-93) In 96 (48%) cases the clinician would not have been surprised if the patient died in the next 6-12 months. In only 5 of these instances were no other prognostic indicators identified (positive predictive value of negative response 95%) 174 (87%) had at least 1 prognostic indicator identified at the time of admission. Prognostic indicators and surprise question Prognostic Indicator Surprise Q “No” (n=96) Surprise Q “Yes” (n=103) N (%) No (%) Co-morbidities (IHD/HF/DM) 45 (47) 43 (42) Wt Loss >10% over 6 months) 9 (9) 2 (2) BMI 3 admissions in 12 mths 35 (37) 8 (8) LTOT 24 (25) 6 (6) MRC 5 44 (46) 16 (16) FEV1 6 courses of steroid in 12 mths 19 (20) 13 (13) HAD Depression >11 26 (27) 23 (23) Of the 15 deaths so far there was a negative response to the surprise question in 14 and in all at least 1 other prognostic indicator was present. Conclusions: Prognostic indicators were present in 87% of patients admitted. The surprise question should form part of admission assessment. It is too early to say which prognostic indicators are important in predicting EOL.

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