Role of comorbidities in stable COPD patients mortality

Objective: to assess the role of comorbidities with all cause mortality in patients with stable COPD Material and Methods: prospective, multicenter, longitudinal study of patients with stable COPD. We recorded demographic characteristics, respiratory functional tests, medication received, comorbidities, Charlson comorbidity index and hospital anxiety and depression scale. Patients were followed up for 3 years. In case of death it was investigated to determine the real cause of death Results: 138 patients were studied with a mean age of 66.3±10.3 years and mean FEV 1 of 51.3±16.9%. The mean Charlson index was 4.66 ± 1.57. 17.2% had depression and 12.7% anxiety. Thirteen (9.5%) patients died, 5 of lung cancer, 5 COPD exacerbation, 1 colon cancer, another for acute myocardial infarction (AMI) and another one for congestive heart failure (CHF). The bivariate analysis showed statistical differences in Charlson index, number of comorbidities, hypertension, AMI, CHF, treatment with noninvasive mechanical ventilation, antidepressants and anxiolytics. In the multivariate analysis the number of comorbidities (HR 1.926; 95%IC: 1.384-2.680) and anxiolytic treatment (HR 4.072; IC95%: 1.106-14.987) showed relationship with mortality. Kaplan-Meier survival plots showed that patients with 2 o more comorbilities, in addition to COPD, have higher mortality than patients with 1 or no comorbidity (35.52±0.2 vs 33±1.3 months, p=0,039). Conclusions: The prevalence of comorbidities in patients with stable COPD was high. Mortality in these patients is related to the number of comorbidities and anxiolytic treatment. Mortality was higher in patients with 2 o more comorbidities. Funded by NEUMOSUR.