Predictors of 6‐Month Mortality in Elderly Patients with Mild Chronic Obstructive Pulmonary Disease Discharged from a Medical Ward After Acute Nonacidotic Exacerbation

Ranieri, Piera; Bianchetti, Angelo; Margiotta, Alessandro; Virgillo, Adriana; Clini, Enrico; Trabucchi, Marco

doi:10.1111/j.1532-5415.2008.01683.x

Cited by 75 publications

(61 citation statements)

References 31 publications

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“…The early and long-term mortality rates reported here are comparable to previous reports on patients hospitalized for an AE-COPD (1-year mortality, 23-36%) (21)(22)(23)(24)(25). Although mortality among patients with COPD who have not had an AE-COPD has not been well studied, 1-year mortality among all patients with COPD aged 65 years or older (regardless of exacerbation history) may be as low as 3 to 4%, even for those with moderate to severe airflow obstruction (26).…”

Section: Original Researchsupporting

confidence: 79%

Early and Long-term Outcomes of Older Adults after Acute Care Encounters for Chronic Obstructive Pulmonary Disease Exacerbation

Genao

Durheim

et al. 2015

Annals ATS

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Rationale: Older patients are at high risk of death and rehospitalization after hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Emergency department visits comprise a substantial portion of acute care encounters in this patient population. The risks of mortality and repeat acute care encounters, including both hospital readmission and repeat emergency department visits, after AE-COPD among older adults are not well understood.Objectives: To examine early and long-term rates of death and repeat acute care encounters after hospitalization or emergency department visit for AE-COPD in Medicare fee-for-service beneficiaries and to identify patient characteristics, including medical comorbid conditions, associated with these outcomes.

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Section: Original Researchsupporting

confidence: 79%

Early and Long-term Outcomes of Older Adults after Acute Care Encounters for Chronic Obstructive Pulmonary Disease Exacerbation

Genao

Durheim

et al. 2015

Annals ATS

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“…Malnutrition has been recognised as a risk factor for mortality [5]. The relationship between malnutrition and mortality has been also confirmed in elderly COPD patients [6].…”

Section: 037)mentioning

confidence: 84%

Ageing and COPD affect different domains of nutritional status: the ECCE study

Battaglia¹,

Spatafora²,

Paglino³

et al. 2010

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners.460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0¡5.9 yrs; forced expiratory volume in 1 s 54.7¡18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment1 (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores.Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were negatively correlated with five MNA items exploring mobility, patient's perception of own nutrition and health status, and arm and calf circumferences (lowest Spearman's rho (rs)5 -0.011; highest p50.039). GOLD stages were independently correlated with body composition and body functionality scores (model r 2 50.073). Age was negatively correlated with four MNA items exploring loss of appetite, fluid intake, mobility and autonomy in daily life (lowest rs5 -0.013; highest p50.030). Age was independently correlated with body functionality score (model r 2 50.037). Severe COPD and ageing are independent and probably concurrent conditions leading to malnutrition. The MNA questionnaire allows a valuable insight into the complexity of components of nutritional status and may provide useful clues for treatment strategies.

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“…MMSE was used to screen the cognitive function during exacerbation period. 10,11 Detailed neuropsychological tests might be time consuming and difficult to perform in the hospitalized COPD subjects although they were performed successfully in a recent study by Dodd et al MMSE still stands as a good alternative for screening.…”

Section: Prevalence Of Cognitive Impairment In Copdmentioning

confidence: 99%

“…For screening, Mini-mental state examination (MMSE) is one of the widely used tools, which can also be used in COPD. 2,3,10,11 It is relatively simple and less time consuming, which is an advantage while assessing a subject recovering from acute exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Is there any association between cognitive status and functional capacity during exacerbation of chronic obstructive pulmonary disease?

et al. 2015

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The aim of this study is to screen the cognitive function during exacerbation of chronic obstructive pulmonary disease (COPD) and investigate whether there is any association between cognitive function and functional impairment, disease severity, or other clinical parameters. Age and sex-matched 133 subjects with COPD exacerbation, 34 stable COPD subjects, and 34 non-COPD subjects were enrolled in this study. For the purpose of this study, mini-mental state examination (MMSE) and Hospital Anxiety and Depression scale were performed. Six-minute walk distance (6MWD) was recorded, and BODE index was calculated. COPD subjects with exacerbation had the lowest MMSE scores (p ¼ 0.022). Frequency of subjects with MMSE score lower than 24 is 22.6, 8.8, and 8.8% in the COPD subjects with exacerbation, stable COPD, and non-COPD control subjects, respectively. The COPD subjects with exacerbation who had MMSE scores lower than 24 were older and less educated. Subjects with COPD exacerbation had shorter 6MWD than that of stable COPD and non-COPD subjects. After controlling for the impact of age and educational level on MMSE, there was no association between 6MWD and MMSE scores in subjects with COPD exacerbation. Cognitive impairment is an important comorbidity during COPD exacerbation. Functional capacity is also lower in exacerbation. However, no association was found between cognitive impairment and functional capacity during exacerbation.

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Predictors of 6‐Month Mortality in Elderly Patients with Mild Chronic Obstructive Pulmonary Disease Discharged from a Medical Ward After Acute Nonacidotic Exacerbation

Abstract: Malnutrition, severity of exacerbation and disability status could be identified as risk factors associated with 6-month mortality of elderly patients admitted for nonacidotic AECOPD.

Cited by 75 publications

References 31 publications

Early and Long-term Outcomes of Older Adults after Acute Care Encounters for Chronic Obstructive Pulmonary Disease Exacerbation

Early and Long-term Outcomes of Older Adults after Acute Care Encounters for Chronic Obstructive Pulmonary Disease Exacerbation

Ageing and COPD affect different domains of nutritional status: the ECCE study

Is there any association between cognitive status and functional capacity during exacerbation of chronic obstructive pulmonary disease?

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