Predictors of mortality in COPD patients after hospitalization due to an exacerbation

Aim: Identify factors related to mortality at 6 months after hospitalization by an acute COPD exacerbation (AECOPD). Method: We performed a 12-month prospective, observational study (July 2017-June 2018) that included COPD patients admitted by an AECOPD. Sociodemographic data, comorbidities, functional and clinical parameters were collected. Mortality at 6 months of admission was considered the end point. Results: 278 consecutive patients were enrolled, of whom 48 (16.2%) died during 6 months after AECOPD. Univariate analysis showed that age (p<0.001), educational standard (p=0.004), BMI (p=0.04), Barthel (p<0.001), mMRC scale (p<0.001), FEV1 (ml) (p=0.03), cardiac failure (p=0.02), cor pulmonale (p=0.01), home oxygen (p=0.01), previous year hospital admissions (p=0.01), total dosis of systemic steroids (p=0.004), pO2 (p=0.02) and pCO2 (p=0.02) at Emergency Room, and non invasive ventilation during the hospitalization (p=0.02) increased risk of mortality after AECOPD. In the multivariate analysis (table 1), factors independently related to mortality were dyspnea grade 2 (p=0.014), 3 (p=0.018) and 4 (p=0.033) by mMRC scale, Barthel Index score (p<0.001) and previous hospitalizations (p=0.023). In ROC analysis, the AUC was 0.83. Conclusions: In COPD patients, Barthel Index, grade of dyspnea and previous hospitalizations are independent risk factors for mortality at 6 months, after hospital admission for AECOPD.