Predictive Model of Hospital Admission for COPD Exacerbation

Abstract

BACKGROUND: The objective of this work was to determine predictive factors of hospital admission for exacerbation during primary care visits in patients with COPD. METHODS: A retrospective cohort study was undertaken to assess risk of hospital admission for COPD exacerbation in primary care patients from November 1, 2010 to October 31, 2013. Data sources were primary care electronic medical records and the hospital discharge minimum data set. A total of 2,501 subjects >40 y of age with a spirometry-based COPD diagnosis were included and followed up for 3 y. The dependent variable was hospital admission for exacerbation; independent variables were: clinical parameters, spirometry results, and severity of disease (according to Global Initiative for Chronic Obstructive Lung Disease criteria). The association of these variables with hospital admission was analyzed with the adjusted odds ratio using a logistic regression model. RESULTS: Mean age of subjects at the beginning of the study was 68.4 y (SD ‫؍‬ 11.6), and 75% were men. Severity was mild in 50.8% of subjects, moderate in 35.3%, severe in 9.4%, and very severe in 4.4%.

Mental disorders in chronic obstructive pulmonary diseases

“…considered the severity (GOLD) to be a very important factor in deciding whether to start a treatment for depression . At the same time, the associated comorbidity was also more prevalent among COPD patients who are hospitalized, a finding previously described …”

“…23 At the same time, the associated comorbidity was also more prevalent among COPD patients who are hospitalized, a finding previously described. 24,25 Hospitalized patients have a higher level of dyspnea (Medical Research Council -MRC). This progressive limitation to the airflow in COPD leads to dyspnea and difficulty in breathing.…”

COPD patients hospitalized with exacerbations have greater cognitive impairment than patients hospitalized with decompensated heart failure

“…Pack year smoking history differed markedly between the groups and was associated with cognitive dysfunction in COPD patients, independent of age and sex. In COPD, smoking load is significantly associated with more severe lung disease22,23 and increased risk of hospitalization 24. Smoking is also a well-recognized cause of vascular disease,25 which can impair cerebral perfusion, altering cognition 26.…”

Chronic Obstructive Pulmonary Disease and Anxiety and Depression Disorders: Prospective Cohort Study in Primary Care

“…López et al considered the severity (GOLD) to be a very important factor on deciding whether to start a treatment for depression [23]. At the same time, the associated comorbidity was also more prevalent among COPD patients who are hospitalised, a finding previously described [24,25].…”