Department of Respiratory Medicine, Allergy and Sleep, National University Hospital, Reykjavik, Iceland.
Int J Chron Obstruct Pulmon Dis. 2012;7:571-6. doi: 10.2147/COPD.S34466. Epub 2012 Sep 14.
Mortality rate is high in patients with chronic obstructive pulmonary disease (COPD). Our aim was to investigate long-term mortality and associated risk factors in COPD patients previously hospitalized for a COPD exacerbation.
A total of 256 patients from the Nordic countries were followed for 8.7 ± 0.4 years after the index hospitalization in 2000-2001. Prior to discharge, the St George's Respiratory Questionnaire was administered and data on therapy and comorbidities were obtained. Information on long-term mortality was obtained from national registries in each of the Nordic countries.
In total, 202 patients (79%) died during the follow up period, whereas 54 (21%) were still alive. Primary cause of death was respiratory (n = 116), cardiovascular (n = 43), malignancy (n = 28), other (n = 10), or unknown (n = 5). Mortality was related to older age, with a hazard risk ratio (HRR) of 1.75 per 10 years, lower forced expiratory volume in 1 second (FEV(1)) (HRR 0.80), body mass index (BMI) <20 kg/m(2) (HRR 3.21), and diabetes (HRR 3.02). Older age, lower BMI, and diabetes were related to both respiratory and cardiovascular mortality. An association was also found between lower FEV(1) and respiratory mortality, whereas mortality was not significantly associated with therapy, anxiety, or depression.
Almost four out of five patients died within 9 years following an admission for COPD exacerbation. Increased mortality was associated with older age, lower lung function, low BMI, and diabetes, and these factors should be taken into account when making clinical decisions about patients who have been admitted to hospital for a COPD exacerbation.
慢性阻塞性肺疾病（COPD）患者的死亡率较高。我们的目的是调查先前因 COPD 加重住院的 COPD 患者的长期死亡率及其相关危险因素。
2000-2001 年指数住院后，对来自北欧国家的 256 例患者进行了 8.7 ± 0.4 年的随访。在出院前，使用圣乔治呼吸问卷（St George's Respiratory Questionnaire）进行评估，并获得治疗和合并症的数据。通过每个北欧国家的国家登记册获取长期死亡率的信息。
在随访期间，共有 202 例患者（79%）死亡，而 54 例患者（21%）仍存活。主要死亡原因为呼吸系统疾病（n = 116）、心血管疾病（n = 43）、恶性肿瘤（n = 28）、其他（n = 10）或未知（n = 5）。死亡率与年龄相关，每增加 10 岁，危险风险比（HRR）增加 1.75；第 1 秒用力呼气量（FEV1）较低（HRR 0.80）；体重指数（BMI）<20 kg/m2（HRR 3.21）；以及糖尿病（HRR 3.02）。年龄较大、BMI 较低和糖尿病与呼吸和心血管死亡率均相关。FEV1 降低与呼吸死亡率之间也存在相关性，而死亡率与治疗、焦虑或抑郁无明显相关性。
近五分之四的患者在因 COPD 加重住院后 9 年内死亡。死亡率增加与年龄较大、肺功能较低、BMI 较低和糖尿病有关，在对因 COPD 加重住院的患者做出临床决策时应考虑这些因素。
