Predicting mortality for patients with exacerbations of COPD and Asthma in the COPD and Asthma Outcome Study (CAOS)

Wildman, M.; Sanderson, Colin; Groves, Jayne; Reeves, Barnaby C; Ayres, Jon G.; Harrison, David A; Young, John; Rowan, Kathy

doi:10.1093/qjmed/hcp036

Cited by 46 publications

(52 citation statements)

References 19 publications

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“…This has been shown in prospective studies on ICU patients [135][136] , as well as in studies where doctors judged the likelihood of survival in a predefined case. Clinicians differ markedly in their decisions to admit and in their prediction of survival of identical patients [137][138] .…”

Section: Prediction Of Mortality In Aecopdmentioning

confidence: 83%

Intensive care in chronic obstructive pulmonary disease : treatment with non-invasive ventilation and long-term outcome

Berkius¹

2013

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Section: Prediction Of Mortality In Aecopdmentioning

confidence: 83%

Intensive care in chronic obstructive pulmonary disease : treatment with non-invasive ventilation and long-term outcome

Berkius¹

2013

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“…ICU admission often occurs after the catastrophic event has occurred. 27 to exacerbations of COPD, [50][51][52][53] which, in turn, are dissimilar from the validated models to predict outcome from acute pulmonary embolism 54,55 or hemoptysis. 56 Respiratory problems of different etiologies may require different models to predict the risk of death and determine which patients are at sufficient risk to warrant intervention.…”

Section: The Current Challenge Of Respiratory Compromisementioning

confidence: 98%

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

et al. 2017

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Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence.

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“…However, there are few studies on the impact of severe exacerbations on the quality of life in this population. (5,8,16,17) …”

Section: Introductionmentioning

confidence: 99%

Chronic obstructive pulmonary disease exacerbation in the intensive care unit: clinical, functional and quality of life at discharge and 3 months of follow up

Viana¹,

Pincelli²,

Pizzichini³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveThe purpose of this study was to evaluate the clinical/functional aspects and quality of life of chronic obstructive pulmonary disease patients who were discharged after an intensive care unit admission for acute respiratory failure.MethodsThis prospective study included chronic obstructive pulmonary disease patients who were admitted to two intensive care units between December of 2010 and August of 2011 and evaluated over three visits after discharge. Thirty patients were included, and 20 patients completed the three-month follow up.ResultsThere was a significant improvement in the following: forced expiratory flow in one second (L) (1.1/1.4/1.4; p = 0.019), six-minute walk test (m) (- /232.8 /272.6; p = 0.04), BODE score (7.5/5.0/3.8; p = 0.001), cognition measured by the Mini Mental State Examination (21/23.5/23.5; p = 0.008) and quality of life measured by the total Saint George Respiratory Questionnaire score (63.3/56.8/51, p = 0.02). The mean difference in the total score was 12.3 (between visits 1 and three). Important clinical differences were observed for the symptom score (18.8), activities score (5.2) and impact score (14.3). The majority of participants (80%) reported they would be willing to undergo a new intensive care unit admission.ConclusionDespite the disease severity, there was a significant clinical, functional and quality of life improvement at the end of the third month. Most patients would be willing to undergo a new intensive care unit admission.

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Predicting mortality for patients with exacerbations of COPD and Asthma in the COPD and Asthma Outcome Study (CAOS)

Abstract: This study has produced an outcome prediction model with slightly better discrimination and much better calibration than the participating clinicians. It has the potential to support risk adjustment and clinical decision making about admission to intensive care.

Cited by 46 publications

References 19 publications

Intensive care in chronic obstructive pulmonary disease : treatment with non-invasive ventilation and long-term outcome

Intensive care in chronic obstructive pulmonary disease : treatment with non-invasive ventilation and long-term outcome

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

Chronic obstructive pulmonary disease exacerbation in the intensive care unit: clinical, functional and quality of life at discharge and 3 months of follow up

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