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Hospitalizations for COPD exacerbations predicted greater mortality

Individuals with COPD exacerbations requiring hospitalization were common and considered a predictor of reduced survival across all COPD stages, according to study results.

Hana Müllerova, PhD, of respiratory epidemiology at GlaxoSmithKline, and colleagues evaluated 2,138 patients with COPD from the ECLIPSE observational study. They determined the incidence, recurrence, risk factors, and mortality for those with exacerbations that necessitated hospital admissions vs. those not admitted during a 3-year follow up.

Twenty-six percent of COPD patients did not have an exacerbation during follow-up, 43% had at least one moderate exacerbation that did not result in hospitalization, and 31% had at least one exacerbation requiring hospitalization (n = 1,452).

Hospitalized patients during the first year of follow-up (n = 289) had an increased risk for repeat hospitalizations during the remaining 2 years (P < .001). The strongest risk factor for future hospitalization was a history of exacerbation resulting in hospitalization 12 months before study entry (HR = 2.71; 95% CI, 2.24-3.29).

Patients with COPD who reported one or more exacerbations during year 1 of follow-up had a higher mortality rate (15% vs. 5%; log rank test, P<.001) compared with those without hospitalizations.

The researchers said the study was limited because data were gathered primarily from patients visiting pulmonary clinics, thus making the results nontransferable to the entire population of COPD patients.

“As we did not collect events of pneumonia, we cannot make statement or ascertain a possible impact of mixed cases of unrecognized pneumonic exacerbations on the estimates of exacerbations occurrence and outcomes,” the researchers wrote.

Disclosure: Müllerova reports being employed by and holding stock in GlaxoSmithKline, the study’s sponsor. Please see the full study for a list of all other authors’ relevant financial disclosures.