Vital prognosis after hospitalization for COPD: a study of a random population sample.

STUDY AIM

To examine survival after admission due to chronic obstructive pulmonary disease (COPD) in a population sample over a time span of 15 years.

DESIGN

Linkage between a prospective population cohort and register information on hospitalization and mortality.

SETTING

The Copenhagen City Heart Study (CCHS).

PARTICIPANTS

A total of 267 men and 220 women who had participated in the CCHS and who were hospitalized with a discharge diagnosis of COPD (ICD-8 491-2).

MAIN RESULTS

The crude 5-yr survival rate after a COPD admission was 45% (37% for men and 52% for women). Mortality risk increased with age and with decreasing forced expiratory volume in 1 s (FEV1)% predicted; for subjects with an FEV1 < or = 40% at the CCHS survey, 5-yr survival after subsequent hospitalization was only 28%. Smoking and presence of chronic mucus hypersecretion at the examination in CCHS were not strongly associated with prognosis. Survival after admission due to COPD did not change significantly over time.

CONCLUSION

Compared to previous studies of COPD patients, the present study indicates that prognosis after hospital admission remains virtually unchanged over the last decades. FEV1 is still the strongest predictor of survival in this patient group.