GOLD staging and grading for predicting one-year mortality in COPD patients with severe exacerbation

Abstract

Introduction: One-year mortality in COPD patients is reported to be between 4-43% depending on group examined and patients9 characteristics. Mortality shows a downward trend in recent studies. Aim: To examine the prediction power of GOLD staging and grading for one-year mortality in COPD patients with severe exacerbation. Methods: 152 COPD patients hospitalized for severe exacerbation were categorized in GOLD grade C or D. All patients completed CAT and mMRC questionnaires and underwent spirometry. One-year mortality was established from National death register. Results: One-year mortality is 7,2% (11/152). No patient in grade C have FEV1 80%, 5,5% in patients with FEV1 between 50-80%, 8,7% in patients with FEV1 between 30-50% and 18,7% in patients with FEV1 50% (11,5 vs 4,4%, p=0.094). CAT test shows similar predicting possibilities with 0% mortality in patients with CAT 0-9, 6,9% in patients with CAT 10-19, 9.7% in patients with CAT 20-29 and 16,4% in patients with CAT>30 (p=0.24). Cox regression shows 3.7% increase in mortality rate for 1% decrease in FEV1 (p Conclusions: This study finds relatively low one-year mortality in COPD patients after surviving severe exacerbation. Grade C and FEV1>80% may be factors for good prognosis. Reduced quality of life and FEV1may be risk factors for increased mortality.