Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry

Abstract

Currently, chronic obstructive pulmonary disease (COPD) represents the fourth cause of death worldwide with significant economic burden. Comorbidities increase in number and severity with age and are identified as important determinants that influence the prognosis. In this observational study, we retrospectively analyzed data collected from the RePoSI register. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients with the clinical diagnosis of COPD. Socio-demographic, clinical characteristics and laboratory findings were considered. The association between variables and in-hospital, 3-month and 1-year follow-up were analyzed. Among 4696 in-patients, 932 (19.8%) had a diagnosis of COPD. Patients with COPD had more hospitalization, a significant overt cognitive impairment, a clinically significant disability and more depression in comparison with non-COPD subjects. COPD patients took more drugs, both at admission, in-hospital stay, discharge and 3-month and 1-year follow-up. 14 comorbidities were more frequent in COPD patients. Cerebrovascular disease was an independent predictor of in-hospital mortality. At 3-month follow-up, male sex and hepatic cirrhosis were independently associated with mortality. ICS-LABA therapy was predictor of mortality at in-hospital, 3-month and 1-year follow-up. This analysis showed the severity of impact of COPD and its comorbidities in the real life of internal medicine and geriatric wards.

Impact of Diabetes Mellitus and Its Comorbidities on Elderly Patients Hospitalized in Internal Medicine Wards: Data from the RePoSi Registry

“…RePoSi is an independent and collaborative registry, organized by the Italian Society of Internal Medicine (SIMI), IRCCS Ca’ Granda Maggiore Policlinico Hospital Foundation, and the Mario Negri Institute for Pharmacological Research, that was made up to recruit, monitor, and evaluate hospitalized older adults ≥65 years admitted to 102 Italian internal medicine and geriatric wards, with data coming from each single medical record, and collected every 2 years from 2008. The project’s design has been previously described in detail [ 10 ]. Briefly, patients were eligible for RePoSi if: (1) they were admitted to one of the participating regional internal medicine wards during the four index weeks chosen for recruitment (one in February, one in June, one in September, and one in December); (2) their age was 65 years or older; (3) they gave informed consent.…”

“…About 60% of elderly subjects with diabetes have one comorbidity, whereas 40% have four or more comorbid chronic conditions [ 7 ]. We previously published data from the RePoSi registry that evidenced clinical impact of comorbidities according to gender differences [ 8 , 9 ] and different diseases in the elderly population hospitalized in internal medicine and geriatric Italian wards [ 10 , 11 ]. Recently, we showed that one of the stronger predictors of in-hospital mortality for older patients admitted in general wards was a glycemia level ≥250 mg/dL [ 12 ].…”

Predictors of short- and long-term mortality among acutely admitted older patients: role of inflammation and frailty

“…In addition to frailty, a cluster of clinical and demographic factors including age and sex is associated with poor prognosis and mortality in elderly patients [7][8][9][10][11][12]. Although studies demonstrated an increased prognostic value of MPI according to sex and older age [13,14], at present these factors are not included in this tool.…”

Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients

“…An observational retrospective study was carried out using the REgistro POliterapie SIMI (REPOSI) database and considering all data collected from January 2010 to December 2016. The REPOSI is a multicenter collaborative observational registry cooperatively established by the Italian Society of Internal Medicine (SIMI), IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation and Mario Negri Institute of Pharmacological Research IRCCS that was made up to recruit, monitor and evaluate hospitalized older adults ≥65 years admitted to 102 Italian internal medicine and geriatric wards with data came from each single medical record and collected every 2 years from 2008 onwards (Nobili et al, 2011;Argano et al, 2020). The study protocol was approved by the local Ethics Committee of the responsible hospitals, and the creation of a database was conducted according to Good Clinical Practice recommendations and the Declaration of Helsinki while maintaining the anonymity of patients.…”