Low BMI, high PaCO2 predict 90-day mortality in severe COPD
High partial pressure of carbon dioxide (PaCO2) and age, low body mass index (BMI), and previous admission for exacerbations of chronic obstructive pulmonary disease (ECOPD) in the last 2 years strongly predict 90-day mortality in patients with severe COPD, according to the Classification and Regression Tree (CART) analysis of a recent study.
“In absence of any of these factors, no patients died, suggesting that this model indeed enables risk stratification,” the authors said.
In total, 364 hospitalized patients (mean age, 70.5 years; 54.4 percent male; mean forced expiratory volume in 1 s [FEV1], 45.2 percent of predicted) were included in the analysis. The rate of in-hospital mortality was 8.5 percent and 90-day mortality 16.2 percent.
The following factors independently predicted 90-day mortality: PaCO2 (odds ratio [OR], 1.31, 95 percent CI, 1.00–0.35), age (OR, 1.09, 0.06–0.11), BMI <18.5 kg/m2 (OR, 2.72, 0.53–1.47) and previous admission for ECOPD in the last 2 years (OR, 1.29, –0.14 to –0.65). According to the CART model, the most discriminatory factors were PaCO2 ≥9.1 kPa, age >80 years, BMI <18.5 kg/m2 and previous admission for ECOPD.
“ECOPD [is] associated with increased in‐hospital and short‐term mortality,” the authors said. “Developing an easy‐to‐use model to predict adverse outcomes will be useful in daily clinical practice and will facilitate management decisions.”
This retrospective, observational, cohort study enrolled all patients with ECOPD admitted to Maastricht University Medical Center between June 2011 and December 2014. The authors considered the last admission and recorded its demographic, clinical and biochemical data.