Hospital General of Castellon, University of Valencia, Castellon, Spain.
Intern Emerg Med. 2011 Feb;6(1):47-54. doi: 10.1007/s11739-010-0465-7. Epub 2010 Oct 1.
We aim to improve knowledge on risk factors that relate to mortality in subjects with exacerbation of chronic obstructive pulmonary disease (COPD) who are hospitalized in General Medicine departments. In a cross-sectional multicenter study, by means of a logistic regression analysis, we assessed the possible association of death during hospitalization with the following groups of variables of participating patients: sociodemographic features, treatment received prior to admission and during hospitalization, COPD-related clinical features recorded prior to admission, comorbidity diagnosed prior to admission, clinical data recorded during hospitalization, laboratory results recorded during hospitalization, and electrocardiographic findings recorded during hospitalization. A total of 398 patients was included; 353 (88.7%) were male, and the median age of the patients was 75 years. Of these patients, 21 (5.3%) died during hospitalization. Only 270 (67.8%) received inhaled β(2) agonists during hospitalization, while 162 (40.7%) received angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The median of predicted FEV(1) prior to admission was 42%. A total of 350 patients (87.9%) had been diagnosed with two or more comorbid conditions prior to admission. An association was found between increased risk of death during hospitalization and the previous diagnoses of pneumonia, coronary heart disease, and stroke. In conclusion, comorbidity is an important contributor to mortality among patients hospitalized in General Medicine departments because of COPD exacerbation.
我们旨在提高对住院治疗的慢性阻塞性肺疾病(COPD)加重患者的死亡率相关风险因素的认识。本研究采用病例对照研究,通过逻辑回归分析评估患者以下几类变量与住院期间死亡的相关性:人口统计学特征、入院前和住院期间的治疗、入院前 COPD 相关临床特征、入院前诊断的合并症、住院期间的临床数据、住院期间的实验室结果以及住院期间的心电图检查结果。共纳入 398 例患者,其中 353 例(88.7%)为男性,中位年龄为 75 岁。其中 21 例(5.3%)患者在住院期间死亡。仅 270 例(67.8%)患者在住院期间接受了吸入β(2)激动剂治疗,而 162 例(40.7%)接受了血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体阻滞剂治疗。入院前预计的 FEV(1)中位值为 42%。350 例(87.9%)患者在入院前被诊断为合并两种或以上的合并症。入院前肺炎、冠心病和中风的诊断与住院期间死亡风险增加相关。总之,合并症是导致因 COPD 加重而住院的患者死亡的一个重要因素。