Arterial blood gas derangement and level of comorbidity are not predictors of long-term mortality of COPD patients treated with mechanical ventilation

Christensen, Steffen; Rasmussen, Lone Banke; Horváth‐Puhó, Erzsébet; Lenler-Petersen, P; Rhode, Marianne G

doi:10.1017/s0265021508004225

Cited by 10 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, most deaths are caused by COPD or the complications of COPD, e.g., cor pulmonale, a finding consistent with studies of medium-term outcomes in ventilated COPD patients (18,19). The likely explanation for this difference in acute and longer-term studies is that patients admitted with COPD exacerbations have their immediate prognosis determined more by the primary reasons for admission, specifically the severity of the exacerbation, than by a co-morbid disease (20).…”

Section: Of Co-morbid Conditions In a Large Cohort Of Copd Patients Isupporting

confidence: 80%

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Roberts¹,

Stone²,

Lowe³

et al. 2011

COPD: Journal of Chronic Obstructive Pulmonary Disease

View full text Add to dashboard Cite

COPD exacerbations resulting in hospitalization are accompanied by high mortality and morbidity. The contribution of specific co-morbidities to acute outcomes is not known in detail: existing studies have used either administrative data or small clinical cohorts and have provided conflicting results. Identification of co-existent diseases that affect outcomes provides opportunities to address these conditions proactively and improve overall COPD care. Cases were identified prospectively on admission then underwent retrospective case note audit to collect data including co-morbidities on up to 60 unselected consecutive acute COPD admissions between March and May in each hospital participating in the 2008 UK National COPD audit. Outcomes recorded were death in hospital, length of stay, and death and readmission at 90 days after index admission. 232 hospitals collected data on 9716 patients, mean age 73, 50% male, mean FEV1 42% predicted. Prevalence of co-morbidities were associated with increased age but better FEV1 and ex-smoker status and with worse outcomes for all four measures. Hospital mortality risk was increased with cor pulmonale, left ventricular failure, neurological conditions and non-respiratory malignancies whilst 90 day death was also increased by lung cancer and arrhythmias. Ischaemic and other heart diseases were important factors in readmission. This study demonstrates that co-morbidities adversely affect a range of short-term patient outcomes related to acute admission to hospital with exacerbations of COPD. Recognition of relevant accompanying diseases at admission provides an opportunity for specific interventions that may improve short-term prognosis.

show abstract

Section: Of Co-morbid Conditions In a Large Cohort Of Copd Patients Isupporting

confidence: 80%

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Roberts¹,

Stone²,

Lowe³

et al. 2011

COPD: Journal of Chronic Obstructive Pulmonary Disease

View full text Add to dashboard Cite

show abstract

“… 12 In patients admitted to ICU, acute derangement is of major importance regarding both short-term 25 , 26 and intermediate-term survival, 15 but long-term survival studies have been conflicting with regard to independent risk predictors. 14 , 27 – 31 …”

Section: Introductionmentioning

confidence: 99%

Assisted ventilation in COPD – association between previous hospitalizations and mortality

Toft-Petersen¹,

Torp‐Pedersen²,

Weinreich³

et al. 2016

COPD

View full text Add to dashboard Cite

BackgroundIn general, previous studies have shown an association between prior exacerbations and mortality in COPD, but this association has not been demonstrated in the subpopulation of patients in need of assisted ventilation. We examined whether previous hospitalizations were independently associated with mortality among patients with COPD ventilated for the first time.Patients and methodsIn the Danish National Patient Registry, we established a cohort of patients with COPD ventilated for the first time from 2003 to 2011 and previously medicated for obstructive airway diseases. We assessed the number of hospitalizations for COPD in the preceding year, age, sex, comorbidity, mode of ventilation, survival to discharge, and days to death beyond discharge.ResultsThe cohort consisted of 6,656 patients of whom 66% had not been hospitalized for COPD in the previous year, 18% once, 8% twice, and 9% thrice or more. In-hospital mortality was 45%, and of the patients alive at discharge, 11% died within a month and 39% within a year. In multivariate models, adjusted for age, sex, mode of ventilation, and comorbidity, odds ratios for in-hospital death were 1.26 (95% confidence interval [CI]: 1.11–1.44), 1.43 (95% CI: 1.19–1.72), and 1.56 (95% CI: 1.30–1.87) with one, two, and three or more hospitalizations, respectively. Hazard ratios for death after discharge from hospital were 1.32 (95% CI: 1.19–1.46), 1.76 (95% CI: 1.52–2.02), and 2.07 (95% CI: 1.80–2.38) with one, two, and three or more hospitalizations, respectively.ConclusionPreceding hospitalizations for COPD are associated with in-hospital mortality and after discharge in the subpopulation of patients with COPD with acute exacerbation treated with assisted ventilation for the first time.

show abstract

“…26 Neither the levels of arterial blood gas values measured immediately before invasive mechanical ventilation was initiated nor the burden of comorbidity were strong determinants of long-term mortality among these patients.…”

Section: Discussionmentioning

confidence: 93%

Role of initial arterial blood gas variations in predicting the outcome of pneumonia patients with type I/II respiratory failure

Rennis

Krishnakumar

2016

Int J Adv Med

View full text Add to dashboard Cite

Arterial blood gas derangement and level of comorbidity are not predictors of long-term mortality of COPD patients treated with mechanical ventilation

Cited by 10 publications

References 28 publications

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Assisted ventilation in COPD – association between previous hospitalizations and mortality

Role of initial arterial blood gas variations in predicting the outcome of pneumonia patients with type I/II respiratory failure

Contact Info

Product

Resources

About

Arterial blood gas derangement and level of comorbidity are not predictors of long-term mortality of COPD patients treated with mechanical ventilation

Cited by 10 publications

References 28 publications

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Co-morbidities and 90-day Outcomes in Hospitalized COPD Exacerbations

Assisted ventilation in COPD &ndash; association between previous hospitalizations and mortality

Role of initial arterial blood gas variations in predicting the outcome of pneumonia patients with type I/II respiratory failure

Contact Info

Product

Resources

About

Assisted ventilation in COPD – association between previous hospitalizations and mortality