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Cited by 131Chronic Obstructive Pulmonary Disease (COPD) ResearchAsthma and respiratory diseasesRespiratory Support and Mechanisms

Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease

Yohannes, Abebaw M., Baldwin, Robert C., Connolly, Martin J.·2005·Age and Ageing
DOI 10.1093/ageing/afi163
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Abstract

INTRODUCTION: acute exacerbation of COPD (AECOPD) is a major cause of hospital admission, and predicts subsequent medium-term mortality. We aimed to examine mortality predictors in patients discharged from hospital after AECOPD. METHODS: we obtained baseline demographic and clinical data from 100 patients (mean age (range)=73 (60-98) years; 48 males) admitted with AECOPD. All completed the following validated questionnaires: a quality of life questionnaire (Breathing Problems Questionnaire; BPQ); a screening questionnaire for depression (Brief Assessment Schedule Depression Cards; BASDEC); a disability questionnaire (Manchester Respiratory Activities of Daily Living questionnaire; MRADL). Following discharge all were prospectively followed and survival/mortality at 12 months confirmed from hospital notes and by contacting general practitioners. RESULTS: the prevalence of depression at recruitment was 56%. One-year mortality in the whole group was 36%. Odds ratios (95% confidence intervals) for mortality predictors (univariate logistic regression analysis) were: use of long-term oxygen therapy=2.72 (1.06-6.97); subsequent readmission=2.57 (1.08-6.12); MRADL score=0.87 (0.80-0.94) (disability predicting death); BASDEC score=1.13 (1.02-1.26) (depression predicting death); BPQ score=1.08 (1.04-1.12) (low quality of life predicting death); length of original hospital stay=1.03 (1.00-1.07). On multivariate logistic regression analysis the only mortality predictor was BPQ with an odds ratio (95% confidence limits) of 1.13 (1.04-1.22). In terms of mortality prediction for individuals, a threshold MRADL score of <12 gave a sensitivity of 86%, specificity of 55%, positive predictive value of 88% and negative predictive value of 52%, with similar predictive values using BPQ as an independent variable. CONCLUSIONS: 1-year mortality after AECOPD admission is high. The presence of depressive illness (which is extremely common), and levels of both disability and impairment of quality of life are univariate predictors of 1-year mortality in this patient group. This model may be useful in predicting prognosis for individuals and thus in guiding treatment decisions.

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  • Lack of treatment for depression and anxiety is associated with poor quality of life and premature death.

    “Lack of treatment is also associated with poor quality of life and premature death.26,34–36”

    From Anxiety and Depression in COPD (2008) · cites this paper as [36]

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Authors
Yohannes, A. M., Baldwin, R. C., & Connolly, M. J.
Affiliations
Manchester Metropolitan University (GB)
Corresponding author
Yohannes, Abebaw M.
ORCID
Venue
Age and Ageing
Publisher
Oxford University Press (OUP)
Published
2005-09-01
Volume
34
Issue
5
Pages
491-496
ISSN
  • 0002-0729 (ISSN-L)
  • 1468-2834
DOI
10.1093/ageing/afi163
OpenAlex
W2150672221
Cited by
131
References
25
Citations by year
2024: 1 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 5 · 2016: 11 · 2015: 9 · 2014: 6 · 2013: 4 · 2012: 11
FWCI
6.66
Type
journal article
Language
en
Open access
closed
Locations
  • Age and Ageing (publishedVersion)
  • PubMed (publishedVersion)
  • e-space (Manchester Metropolitan University) (submittedVersion)
Funders
University of Manchester
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
COPD exacerbations, chronic obstructive pulmonary disease, one-year mortality, mortality risk factors, quality of life, depression, disability, long-term oxygen therapy, hospital readmission, prognosis, length of hospital stay, older adults, post-discharge follow-up, risk stratification, treatment decision-making
MeSH terms
Aged, Aged, 80 and over, Depression, Female, Persons with Disabilities, Humans, Length of Stay, Male, Middle Aged, Patient Discharge, Prospective Studies, Quality of Life, Surveys and Questionnaires, Regression Analysis, Pulmonary Disease, Chronic Obstructive

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