Piquet et al identified predictors for mortality following an acute exacerbation of COPD requiring hospitalization. This can help to identify a patient who may benefit from more aggressive management. The authors are from La Raincy-Montfermeil Hospital, Antibes General Hospital, Etbeuf General Hospital, Compiegne General Hospital, Meaux General Hospital and University Paris Descartes in France (French College of General Hospital Respiratory Physicians, CPHG).
Patient selection: adult hospitalized for an acute exacerbation of COPD
Outcome: 4-year (48 month) mortality
Predictors of mortality
(1) age >= 80 years (relative risk 3) or age 60 to 79.9 years (relative risk 1.7)
(2) BMI <= 20 kg per square meter (perhaps indicative of cachexia)
(3) ischemic heart disease or congestive heart failure (cardiovascular disease)
(4) 2 or more previous hospital admissions for an acute exacerbation within the previous year
(5) lower limb edema within the first 24 hours of current admission
(6) oxygen therapy at hospital discharge
(7) lung cancer
Factors protective for the patient:
(1) BMI >= 25 kg per square meter
(2) GERD
The presence of several predictors indicates a high-risk profile.
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