Predictors of hospitalisation and death with acute exacerbations of COPD

Background: Acute exacerbations of COPD (AECOPD) are common causes of attendance to hospital emergency department (ED), but there are limited data on decision making about hospitalisation. Aims: To analyse decision making for hospitalisation and predictors of death in patients attended with AECOPD in a public hospital in Australia. Methods: All patients with a diagnosis of AECOPD attending the ED of the Royal Hobart Hospital between November 2006 and July 2008 (21 months) were reviewed. Patients who were admitted to the hospital were compared with those who were discharged home. Survival analysis was used to find predictors of death. Results: 150 patients with 218 admissions (50% female, 42% current- and 58% ex-smokers, 24% with history of heart disease and 5% with previous history of myocardial infarction) were included in the study. Those discharged from ED had a lower heart rate/minute than those admitted [mean (SD) 96 (17) vs. 105 (19), p Conclusions: Decision making for hospitalisation of patients in the ED seems largely arbitrary. Cardiac disease was the strongest predictor of death.