Role of comorbidities on mortality in patients hospitalized for COPD exacerbations

Introduction: Comorbidities can play a role in mortality among patients with hospitalization for COPD exacerbation (COPDE) and after these hospitalizations. Objective: To assess the influence of comorbidities on mortality in patients hospitalized for COPDE and during 3-years follow up after hospitalization. Methods: prospective, observational study of patients hospitalized for COPDE between June 2009 and May 2010, and during 3 years follow-up after hospitalization. We recorded in-hospital mortality for COPDE and the whole mortality during 3 years follow-up. Demographic variables, GOLD stage, arterial blood gases and blood analysis, use of non-invasive ventilation (NIV), basal MRC dyspnea scale and comorbidities, including Charlson index were recorded. Results: we studied 177 patients hospitalized for COPDE. The mortality rate was 15.8% (28 patients). The global mortality during the 3 years was 20.3% (36 patients). In both groups, the mean age was significantly higher in patients that died, and they have more dyspnea, higher GOLD stage and PaCO 2 , more number of comorbidities, required more NIV, and have lower hemoglobin levels. In the 3 years follow-up the mortality was higher in patients the used more long term oxygen therapy and those with higher Charlson index. In multivariate analysis the need for NIV was significantly associated with in-hospital mortality, and hemoglobin and Charlson index were significantly associated with the whole 3 years follow-up mortality. Conclusions: The need for NIV was associated with higher in-hospital mortality for COPDE. The whole 3 years mortality after hospitalization for COPD exacerbation was associated with higher Charlson index and lower hemoglobin levels.