Chang Chun, Yao Wan-zhen, Fang Tian-shu
Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2011 Mar 29;91(12):824-7.
To study the causes of chronic obstructive pulmonary disease (COPD)-related death and influencing factors of survival time from first hospitalization due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
All patients with a primary or secondary diagnosis of COPD (International Classification of Diseases (ICD)-10 Codes J40-J47) were continuously enrolled at our hospital from January 2006 to December 2008. A retrospective review was performed on the medical records of COPD patients who died during hospitalization. The causes of death were coded and analyzed according to the International Classification of Diseases (ICD)-10. The underlying causes of death were identified and ranked in order of prevalence. The medical records of first hospitalization due to AECOPD were reviewed. Retrospective analysis was performed for the clinical data. And Cox regression analysis was used to select the independent risk factors of influencing the survival time.
Sixty-seven patients died during hospitalization. The median FEV(1) (forced expiratory volume in 1 second percentage) was 34%. The causes of death in the COPD inpatients were as follows: respiratory diseases (n = 39), cardio-cerebrovascular diseases (n = 16), malignant tumors (n = 10), diabetes mellitus (n = 1) and suicide (n = 1). Among them, 54 patients had a history of hospitalization due to AECOPD. Thirteen deceased patients were never hospitalized because of AECOPD. The mean interval between the first admission with AECOPD as the primary diagnosis and death was 38 months (range: 1 - 159). The independent risk factors of influencing the survival time were as follows: complications with coronary artery disease & severe pulmonary hypertension, age, body mass index (BMI) and serum level of C-reactive protein (CRP) (all P < 0.05).
The major cause of death in moderate-severe COPD patients is respiratory disease. complicated with coronary artery disease & severe pulmonary hypertension, age, BMI and serum level of CRP are the independent risk factors of affecting the survival time from first hospitalization due to AECOPD.
研究慢性阻塞性肺疾病（COPD）相关死亡原因及慢性阻塞性肺疾病急性加重（AECOPD）首次住院后生存时间的影响因素。
2006年1月至2008年12月期间，我院连续纳入所有原发性或继发性诊断为COPD（国际疾病分类（ICD）-10编码J40-J47）的患者。对住院期间死亡的COPD患者病历进行回顾性分析。根据国际疾病分类（ICD）-10对死亡原因进行编码和分析。确定潜在死亡原因并按患病率排序。回顾性分析AECOPD首次住院病历，对临床资料进行回顾性分析。采用Cox回归分析选择影响生存时间的独立危险因素。
67例患者住院期间死亡。第1秒用力呼气容积（FEV₁）中位数为34%。COPD住院患者的死亡原因如下：呼吸系统疾病（n = 39）、心脑血管疾病（n = 16）、恶性肿瘤（n = 10）、糖尿病（n = 1）和自杀（n = 1）。其中，54例患者有因AECOPD住院史。13例死亡患者从未因AECOPD住院。以AECOPD为主要诊断的首次入院至死亡的平均间隔时间为38个月（范围：1 - 159个月）。影响生存时间的独立危险因素如下：合并冠状动脉疾病和重度肺动脉高压、年龄体重指数（BMI）和血清C反应蛋白（CRP）水平（均P < 0.05）。
中重度COPD患者的主要死亡原因是呼吸系统疾病。合并冠状动脉疾病和重度肺动脉高压、年龄、BMI和血清CRP水平是影响AECOPD首次住院后生存时间的独立危险因素。
