Prognostic factors associated with poor outcomes among multiethnic patients with acute exacerbation of chronic obstructive pulmonary disease
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 481 - 490
DOI: https://doi.org/10.5372/1905-7415.0904.417
Keywords
© 2015 Sana’ M.H. Al Aqqad, Balamurugan Tangiisuran, Irfhan Ali Hyder Ali, Teo Ley Khim, Graham Davies
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Acute exacerbation is the most common cause of hospitalization for patients with chronic obstructive pulmonary disease (COPD).
Objectives
To investigate prognostic factors associated with poor outcomes after acute exacerbation of COPD.
Methods
A retrospective study of patients with a diagnosis of acute exacerbation of COPD (AECOPD) admitted to hospital in Penang over 5-year periods between January 2007 and December 2011 were conducted. We analyzed survival data using a Kaplan-Meier curves, and Cox regression was used to identify prognostic factors for mortality and readmission.
Results
The study included 259 patients with a median age of 70 years (interquartile range = 59.7-76.7 years), and men comprised 92.7% of the cohort. Mortality after 1, 3, and 5 years was 26.3%, 49.8%, and 59.5% respectively. Older age (hazard ratio (HR), 2.53; 95% confidence interval (CI), 1.29-4.92) and long-term oxygen therapy (LTOT) at discharge (HR, 2.78; 95% CI, 1.54-5.02) were identified as independent prognostic factors associated with a higher risk of mortality after discharge. The risk of hospital readmission was 34% for 1 year, 43.2% for 3 years, and 48.6% for 5 years. Older age (HR, 1.78; 95% CI, 1.12-2.85), LTOT at discharge (HR, 3.63; 95% CI, 1.89-6.95), frequency of admissions in the previous year (HR, 2.92; 95% CI, 1.47-5.80), and being ventilated (HR, 0.19; 95% CI, 0.08-0.47) were identified as prognostic factors associated with readmission.
Conclusions
Patients surviving AECOPD were prone to poor outcomes. Older patients and those discharged with LTOT were at higher risk of mortality and readmission at any time.