One-year mortality after severe COPD exacerbation in Bulgaria

Mekov, Evgeni; Slavova, Yanina; Tsakova, Adelina; Genova, M; Kostadinov, Dimitar; Minchev, Delcho; Marinova, Dora; Boyanov, Mihail

doi:10.7717/peerj.2788

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…The 12-month mortality rate was significantly and markedly lower in the DM group (1.9%) than in the UM group (14.2%), the latter of which is consistent with, or lower than, the 12-month mortality rates of 12.5% [28], 16.8% [29], 21% [30] and >23% [31] that have been reported previously for COPD patients following a hospitalisation for an acute exacerbation of COPD. That mortality was lower than expected in the DM group, rather than excessively high in the UM group, suggests that the disease management intervention reduced mortality.…”

Section: Discussionsupporting

confidence: 89%

COMET: a multicomponent home-based disease-management programmeversusroutine care in severe COPD

et al. 2018

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The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned all-cause hospitalisation days in the intention-to-treat (ITT) population. Secondary end-points included acute care hospitalisation days, BODE (body mass index, airflow obstruction, dyspnoea and exercise) index and exacerbations. Safety end-points included adverse events and deaths.For the 157 (disease management) and 162 (usual management) patients eligible for ITT analyses, all-cause hospitalisation days per year (mean±sd) were 17.4±35.4 and 22.6±41.8, respectively (mean difference -5.3, 95% CI -13.7 to -3.1; p=0.16). The disease management group had fewer per-protocol acute care hospitalisation days per year (p=0.047), a lower BODE index (p=0.01) and a lower mortality rate (1.9% 14.2%; p<0.001), with no difference in exacerbation frequency. Patient profiles and hospitalisation practices varied substantially across countries.The COMET disease management intervention did not significantly reduce unplanned all-cause hospitalisation days, but reduced acute care hospitalisation days and mortality in severe COPD patients.

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Section: Discussionsupporting

confidence: 89%

COMET: a multicomponent home-based disease-management programmeversusroutine care in severe COPD

et al. 2018

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“…Our analyses show that the overall mortality for COPD exacerbation in hospitalized patients was lower than previously reported ranges 37–41 . Studies that reported higher estimates were performed in patients followed up to a year after the index admission, 37,39 while our analyses included only in‐hospital mortality.…”

Section: Discussionmentioning

confidence: 55%

“…Our analyses show that the overall mortality for COPD exacerbation in hospitalized patients was lower than previously reported ranges. [37][38][39][40][41] Studies that reported higher estimates were performed in patients followed up to a year after the index admission, 37,39 while our analyses included only in-hospital mortality. Our analysis also does not include deaths among patients transferred to a skilled nursing facility or intermediate care facility or those who died at home.…”

Section: Discussionmentioning

confidence: 99%

Muscle loss contributes to higher morbidity and mortality in COPD: An analysis of national trends

et al. 2020

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Background and objective COPD is the third most common cause of death worldwide and fourth most common in the United States. In hospitalized patients with COPD, mortality, morbidity and healthcare resource utilization are high. Skeletal muscle loss is frequent in patients with COPD. However, the impact of muscle loss on adverse outcomes has not been systematically evaluated. We tested the hypothesis that patients hospitalized for COPD exacerbation with, compared to those without, a secondary diagnosis of muscle loss phenotype (all ICD‐9 codes associated with muscle loss including cachexia) will have higher mortality and cost of care. Methods The NIS database of hospitalized patients in 2011 (1 January–31 December) in the United States was used. The impact of a muscle loss phenotype on in‐hospital mortality, LOS and cost of care for each of the 174 808 hospitalizations for COPD exacerbations was analysed. Results Of the subjects admitted for a COPD exacerbation, 12 977 (7.4%) had a secondary diagnosis of muscle loss phenotype. A diagnosis of muscle loss phenotype was associated with significantly higher in‐hospital mortality (14.6% vs 5.7%, P < 0.001), LOS (13.3 + 17.1 vs 5.7 + 7.6, P < 0.001) and median hospital charge per patient ($13 947 vs $6610, P < 0.001). Multivariate regression analysis showed that muscle loss phenotype increased mortality by 111% (95% CI: 2.0–2.2, P < 0.001), LOS by 68.4% (P < 0.001) and the direct cost of care by 83.7% (P < 0.001) compared to those without muscle loss. Conclusion In‐hospital mortality, LOS and healthcare costs are higher in patients with COPD exacerbations and a muscle loss phenotype.

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“…Mekov et al discovered that the risk factors for increased mortality were age, FEV 1 values, severe exacerbation in the previous year, and reduced quality of life. 48 Chronic bronchitis increased all-cause mortality and mortality from respiratory causes, cardiovascular diseases, and cancer. 23 In our study, early onset patients had more frequent exacerbation and poorer health status, which could cause death at younger ages.…”

Section: Discussionmentioning

confidence: 99%

The outcome and the influencing factors of the age of onset in post-mortem of chronic bronchitis patients: a retrospective study

Zhu

Luo

et al. 2018

COPD

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PurposeChronic bronchitis is thought to occur in elderly patients, and smoking seems to be an important risk factor. The outcomes related to the age of onset in patients with chronic bronchitis are still unclear.Patients and methodsA retrospective study was conducted on deceased patients whose diagnosis included bronchitis from 2010 to 2016. Patients were separated into two groups according to the age of onset (Group I, age ≤50 years old; Group II, age >50 years old). Information regarding disease course, smoking history, death age, number of admissions per year, Hugh Jones Index, and self-reported comorbidities of the patients was recorded.ResultsThe courses of chronic cough and sputum were 33.38±7.73 years and 14.44±8.60 years in Group I and Group II, respectively (p<0.05). The death ages of Group I and Group II were 77.65±7.87 years and 84.69±6.67 years, respectively (p<0.05). There was a significant negative correlation between the number of hospital admissions per year and the age of onset. The age of onset was negatively associated with daily smoking count (r=−0.210) and total smoking count (r=−0.146). In Group I, there were fewer cases of coronary heart disease (OR =0.41 [0.24–0.71]), neurological diseases (OR =0.48 [0.24–0.97]), and total comorbidities (OR =0.67 [0.54–0.85]) than in Group II.ConclusionPatients with early onset chronic bronchitis had a longer history, younger death age, poorer health status, and lower incidence of comorbidities.

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One-year mortality after severe COPD exacerbation in Bulgaria

Cited by 10 publications

References 27 publications

COMET: a multicomponent home-based disease-management programmeversusroutine care in severe COPD

COMET: a multicomponent home-based disease-management programmeversusroutine care in severe COPD

Muscle loss contributes to higher morbidity and mortality in COPD: An analysis of national trends

The outcome and the influencing factors of the age of onset in post-mortem of chronic bronchitis patients: a retrospective study

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