Mortality predictors in patients with exacerbation of chronic obstructive pulmonary disease

Abstract

Background:

Chronic obstructive pulmonary disease (COPD) is a health problem and the third cause of death in the world. Mortality is higher in patients who present exacerbations of this disease.

Objective:

To determine mortality predictors in hospitalized patients with exacerbation of COPD in a second care level hospital in Cuba.

Methodology:

A cross-sectional study was conducted at Camilo Cienfuegos Provincial General Hospital in Sancti Spíritus, for two years. 335 patients were included. The variables collected were grouped into sociodemographic, clinical, associated chronic diseases and patient status at discharge. A decision tree was developed using the exhaustive Chaid method, the dependent variable was mortality from COPD.

Results:

Female patients (55.2 %), 60 years or older (79 %) and with more than 4 exacerbations in the last year (53.1 %) predominated. The decision tree model had a sensitivity of 97 %, a specificity of 89.3 %, and an overall percentage of correct diagnosis of 93.1 %. Six variables that predicted mortality were identified: acute respiratory failure, diagnosis of pneumonia, non-use of antithrombotics, pulmonary thromboembolism, age over 60 years, and smoking.

Conclusions:

The highest probability of dying during an exacerbation of COPD occurs among patients with acute respiratory failure, those who are diagnosed with pneumonia during admission, those who do not receive antithrombotic treatment and those who are over 60 years of age.