Risk stratification for short‐term mortality at hospital admission for acute exacerbations of COPD

• Published in: Respirology (Carlton, Vic.) Vic.), 2019-08, Vol.24 (8), p.765-776
• Main Authors: Sprooten, Roy T.M., Rohde, Gernot G.U., Lawyer, Glenn, Leijte, Wouter T., Wouters, Emiel F.M., Franssen, Frits M.E.
• Format: Article
• Language: English
• Subjects: Age; Body mass index; Chronic obstructive pulmonary disease; exacerbations; hospitalisations; Lung diseases; Mortality; Obstructive lung disease; Patients; predictors; Respiratory diseases; Risk factors
• ISSN: 1323-7799; 1440-1843
• DOI: 10.1111/resp.13538

ABSTRACT Background and objective Exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with increased in‐hospital and short‐term mortality. Developing an easy‐to‐use model to predict adverse outcomes will be useful in daily clinical practice and will facilitate management decisions. We aimed to assess mortality rates and potential predictors for short‐term mortality after severe ECOPD. Classification and Regression Tree (CART) model was used to identify predictors of adverse outcome. Methods A retrospective observational cohort study, including all patients admitted to Maastricht University Medical Center with ECOPD between June 2011 and December 2014 was performed. The last admission was taken into account, and its demographic, clinical and biochemical data were recorded. Results A total of 364 hospitalized patients were enrolled. Mean (SD) age was 70.5 (10.2) years, 54.4% were male and mean FEV1 45.2% (17.7) of predicted. The in‐hospital and 90‐day mortality were, respectively, 8.5 and 16.2%. Independent risk factors for 90‐day mortality were: PaC02 (odds ratio (OR): 1.31; 95% confidence interval (CI): 1.00–0.35), age (OR: 1.09; CI: 0.06–0.11), body mass index (BMI)  80 years, BMI