[Mortality and comorbidity in hospitalized chronic obstructive pulmonary disease patients]

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a fourth cause of death in USA and is expected to be the third cause of death by year 2020. It is believed that some diseases like cardiovascular diseases, osteoporosis, cachexia, anaemia are systemic consequences of COPD. Some data show that the co-morbidities are more frequent in severe COPD patients than in control groups and are associated with the serious health outcomes. It is debated whether extra pulmonary comorbidities or pulmonary complications are the main reason of death in COPD. The aim of the study was to analyze the mortality and comorbidity in COPD patients who died during hospitalization in the Department of Pneumonology and Allergology in WMU from 2004 to 2008.

Material and methods: We analyzed 266 records of patients who had diagnosis of COPD and died during hospitalization (179 [67%] M and 87 [33%] F). The mean age at death was 73 ± 8 years (M 73 ± 8 years, F 74 ± 9 years).

Results: The most frequent cause of death were: COPD exacerbation (n = 81 [30%], F = 32, M = 49), pneumonia (n = 67 [25%], F = 17, M = 50), lung cancer (n = 50 [19%], F = 18, M = 32), ischemic heart disease (n = 20 [7%], F = 5, M = 15), cardiovascular insufficiency (n = 14 [5%], F = 6, M = 8) and other (n = 34 [14%]). The lung cancer was more frequent cause of death in younger patients (p = 0.002), and pneumonia in older (p = 0.02). In COPD patients the following comorbidities were diagnosed: chronic heart failure (n = 169), hypertension (n = 103), ischaemic heart disease (n = 102), diabetes mellitus type 2 (n = 55), renal insufficiency (n = 43), hypertrophy of prostate (n = 36), arteriosclerosis obliterans (n = 28), osteoporosis (n = 19), anaemia (n = 14) and others.

Conclusions: 1. The most frequent reasons of death were related to respiratory system: COPD exacerbation, pneumonia and lung cancer. 2. The most frequent diseases coexisting with COPD were cardiovascular disease, respiratory insufficiency and diabetes mellitus.