Abstract
BackgroundChronic obstructive pulmonary disease (COPD) has been the only leading cause of death associated with a continuously increasing trend in the US over the past 30 years.ObjectivesThe aim of this research was to identify predictors for all-cause in-hospital mortality for COPD patients.MethodsWe conducted a cross-sectional study of patients with the discharge diagnosis of COPD, utilizing the 2007 Premier Perspective database. Inpatients aged 40 years and above were selected if they had a discharge with a primary diagnosis of COPD between January 1, 2007 and December 31, 2007. All data analyses were based on individual level. If a patient had multiple discharges, only the last discharge was included for mortality analysis. Predictors for mortality were identified by multiple logistic regressions. Bonferroni correction for multiple logistic regression models was adapted to control for family-wise errors.ResultsThe total of 57,224 patients was selected for data analysis in the study. All-cause in-hospital mortality for patients with COPD was 2.4%. Older age, insurance coverage, elective admission, intensive care unit admission, prolonged length of stay, increased Deyo-adapted Charlson Index (DCI) score and Elixhauser comorbidities of renal failure, metastatic cancer, solid tumor without metastasis, and weight loss were identified as independent predictors for all-cause in-hospital mortality. Antibiotics and β-blockers were predictors of lower all-cause in-hospital mortality risk after adjusting for other factors.ConclusionsThe nationwide discharge database provides useful information to identify predictors for all-cause in-hospital mortality of patients with COPD.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-359) contains supplementary material, which is available to authorized users.
Highlights
Chronic obstructive pulmonary disease (COPD) has been the only leading cause of death associated with a continuously increasing trend in the US over the past 30 years
A review by Steer et al discovered that older age, lower diminished forced expiratory volume in one second (FEV1), current smoking, prior hospitalization, poor nutrition status, as well as specific chronic comobidities were the predictors for both inhospital and post-discharge mortality; and acute comorbidites were only independently associated with in-hospital mortality (Steer et al 2010)
We explored the factors associated with allcause, in-hospital mortality during COPD related hospital admissions based on a nationally representative, administrative hospital discharge database
Summary
Chronic obstructive pulmonary disease (COPD) has been the only leading cause of death associated with a continuously increasing trend in the US over the past 30 years. A review by Steer et al discovered that older age, lower diminished forced expiratory volume in one second (FEV1), current smoking, prior hospitalization, poor nutrition status, as well as specific chronic comobidities were the predictors for both inhospital and post-discharge mortality; and acute comorbidites were only independently associated with in-hospital mortality (Steer et al 2010). Another recently published systematic review reported that some specific comorbid conditions, such as low body mass index (BMI) and cardiac failure, were significantly associated with both long-term and short-term in-hospital mortality (Singanayagam et al 2013). There has been a controversy whether a routinely used comorbidity measure such as the Charlson
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