In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease
In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease
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DOI：
10.1001/archinte.163.10.1180
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发表时间：
2003-05-26
影响因子：
--
通讯作者：
Diette, GB
中科院分区：
文献类型：
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作者：
Patil, SP;Krishnan, JA;Diette, GB
背景：慢性阻塞性肺疾病（COPD）急性加重是美国住院的常见原因。先前对选定的COPD患者人群的研究估计院内死亡率为4%至30%。我们的目的是获得一个概括性的估计，在美国的COPD急性加重住院死亡率，并确定预测因素的住院死亡率使用administrative data.Methods：我们进行了一项横断面研究，利用1996年全国住院病人样本，数据集的所有住院从20%的非联邦美国医院的样本。研究人群包括71130例出院时COPD急性加重的40岁或以上患者。评估的主要结果是院内死亡率。结果：COPD急性加重患者的院内死亡率为2.5%。多变量分析确定了年龄较大，男性，较高的收入，非常规的入院来源，以及更多的合并症作为独立的危险因素在医院mortality.Conclusions：在这个全国范围内的样本COPD急性加重患者住院期间的死亡率低于以前的研究选择的人群。这一估计应该为临床医生和患者提供关于需要住院治疗的COPD急性加重的乐观估计。我们的研究结果表明，使用管理数据可以帮助确定COPD急性加重患者的亚组，这些患者的院内死亡风险较高。
Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a frequent cause of hospitalization in the United States. Previous studies of selected populations of patients with COPD have estimated in-hospital mortality to range from 4% to 30%. Our objective was to obtain a generalizable estimate of in-hospital mortality from acute exacerbation of COPD in the United States and to identify predictors of in-hospital mortality using administrative data.Methods: We performed a cross-sectional study utilizing the 1996 Nationwide Inpatient Sample, a data set of all hospitalizations from a 20% sample of nonfederal US hospitals. The study population included 71130 patients aged 40 years or older with an acute exacerbation of COPD at hospital discharge. The primary outcome assessed was in-hospital mortality.Results: In-hospital mortality for patients with an acute exacerbation of COPD was 2.5%. Multivariable analyses identified older age, male sex, higher income, nonroutine admission sources, and more comorbid conditions as independent risk factors for in-hospital mortality.Conclusions: Mortality during hospitalization in this nationwide sample of patients with acute exacerbations of COPD was lower than that of previous studies of select populations. This estimate should provide optimism to both clinicians and patients regarding prognoses from COPD exacerbations requiring hospitalization. Our results indicate that the use of administrative data can help to identify subsets of patients with acute exacerbations of COPD that are at higher risk of in-hospital mortality.