Survival in COPD patients with hospitalization due to exacerbation

Background / Objectives The increase in the number of exacerbations and comorbidities in COPD carries a worse prognosis and survival. The new GOLD 2014 classification includes patients with one hospital exacerbation in the C and D groups. Our goal was to observe in a cohort of COPD patients, the overall survival and relate it with the number of exacerbations and associated comorbidity. Methods Retrospective, observational study of COPD patients, hospitalized with at least one exacerbation in 2009. Subsequently we followed to determine overall survival at 3 years and related to the number of exacerbations, comorbidity measured by the Charlson index, the new 2014 GOLD and phenotype classification by GesEPOC guide. Results 212 patients, 77.8 % men and 22.2% women were studied, mean age of 73.32 + 9.98 years, mean FEV1 of 48.68 + 16.85%, number of exacerbations average of 1.94 + 1.31, the mean value of 2.3 + mMRC scale and index 0.9 Average Charlson 5.84 + 2.02. At follow-up, 89 patients died. Median survival could not be calculated because follow up finished with a cummulative survival greater than 50 %. The age-adjusted survival was lower in exacerbator phenotypes (C and D ) of the GesEPOC (HR 2.142, CI 95 % 1390-3303 , p : 0.0004 ). The risk of mortality in patients with Charlson index > 5 is 72.1 % ( HR: 1.721 , CI: 1077-2749, p : 0.0184 ). Finally, our patients with > 2 exacerbations in a year, have a 84 % risk of death ( HR: 1.841 , CI 95 % 1205-2812 , p : 0.0044) Conclusions In our population of patients hospitalized for at least one exacerbation COPD, survival decreased in patients with more exacerbations and comorbidity measured by the Charlson index and was lower in exacerbator phenotypes of the GesEPOC.