Impact of Coexisting Dementia on Inpatient Outcomes for Patients Admitted with a COPD Exacerbation

People with COPD are at a higher risk of cognitive dysfunction than the general population. However, the additional impact of dementia amongst such patients is not well understood, particularly in those admitted with a COPD exacerbation. We assessed the impact of coexisting dementia on inpatient mor...

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Bibliographic Details
Published in:International journal of chronic obstructive pulmonary disease 2022, Vol.17, p.535-544
Main Authors: Gupta, Ayushman, McKeever, Tricia M, Hutchinson, John P, Bolton, Charlotte E
Format: Article
Language:English
Subjects:
Age
Analysis
Chronic obstructive pulmonary disease
Cognition & reasoning
Cognitive ability
Comorbidity
Dementia
exacerbation
Length of stay
Lung diseases, Obstructive
morbidity
Mortality
Original Research
Patient outcomes
Patients
Regression analysis
United Kingdom
Variables
Ventilation
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Summary:People with COPD are at a higher risk of cognitive dysfunction than the general population. However, the additional impact of dementia amongst such patients is not well understood, particularly in those admitted with a COPD exacerbation. We assessed the impact of coexisting dementia on inpatient mortality and length of stay (LOS) in patients admitted to hospital with a COPD exacerbation, using the United States based National Inpatient Sample database. Patients aged over 40 years and hospitalised with a primary diagnosis of COPD exacerbation from 2011 to 2015 were included. Cases were grouped into patients with and without dementia. Multivariable logistic regression analysis, stratified by age, was used to assess risk of inpatient deaths. Cox regression was carried out to compare death rates and competing risk analysis gave estimates of discharge rates with time to death a competing variable. A total of 576,381 patients were included into the analysis, of which 35,372 (6.1%) had co-existent dementia. There were 6413 (1.1%) deaths recorded. The odds of inpatient death were significantly greater in younger patients with dementia (41-64 years) [OR (95% CI) dementia vs without: 1.75 (1.04-2.92), p=0.03]. Cases with dementia also had a higher inpatient mortality rate in the first 4 days [HR (95% CI) dementia vs without: 1.23 (1.08-1.41), p=0.002] and a longer LOS [sub-hazard ratio (95% CI) dementia vs without: 0.93 (0.92-0.94), p
ISSN:1178-2005
1176-9106
1178-2005
DOI:10.2147/COPD.S345751