Management and survival of patients admitted with an exacerbation of COPD: Comparison of two Danish patient cohorts

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Abstract
Introduction:  The aim of this study was to describe the management and prognosis related to a hospital admission for acute exacerbation of chronic obstructive pulmonary disease and to compare results to an earlier study.Objectives and Methods:  This is a retrospective study of 300 consecutively discharged patients admitted in 2006–2007 with an exacerbation of chronic obstructive pulmonary disease from three respiratory departments. Data were collected from patient charts and compared with a replicate study done in 2001.Results:  The mean age was 72.1 years; 61.7% were women. Mean forced expiratory volume in 1 s was 37.6% of predicted. On admission, 11.3% were treated with non‐invasive ventilation, and 84.3% were given systemic corticosteroids. In‐hospital mortality was 4.7%. At discharge, treatment with inhaled corticosteroids or at least one long‐acting bronchodilator was given to 86.7% and 89% of patients, respectively, which was significantly higher than for similarly sampled patients in 2001. Mortality in 30 days and 1 year after discharge was 4.5% and 25.5%, respectively, compared with 5.5% and 30.3% in 2001, the 12‐month mortality being significantly lower (P = 0.03). Readmission rate in the 12 months following discharge was 42.3%. Long‐term oxygen treatment, treatment with anti‐dysrhythmic drugs and lack of outpatient follow‐up were independent predictors of 1‐year mortality. Risk of readmission was increased with dependence in self‐care activities, previous admissions and treatment with strong analgesics.Conclusions:  Over a period of 6 years, a significantly higher number of patients are being treated according to guidelines. Survival following discharge increased over the same period.Please cite this paper as: Eriksen N and Vestbo J. Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts. The Clinical Respiratory Journal 2010; 4: 208–214.

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