Assisted ventilation in COPD – association between previous hospitalizations and mortality
Anne Pernille Toft-Petersen,1,2 Christian Torp-Pedersen,1,3 Ulla Møller Weinreich,1,4 Bodil Steen Rasmussen1,2 1Department of Clinical Medicine, Aalborg University, 2Department of Anaesthesia and Intensive Care, Aalborg University Hospital, 3Department of Health, Science and Technology,...
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doaj-7effcb12d4f84839b20f522047801e352020-11-25T00:26:42ZengDove Medical PressInternational Journal of COPD1178-20052016-05-012016Issue 193594326742Assisted ventilation in COPD – association between previous hospitalizations and mortalityToft-Petersen APTorp-Pedersen CWeinreich UMRasmussen BSAnne Pernille Toft-Petersen,1,2 Christian Torp-Pedersen,1,3 Ulla Møller Weinreich,1,4 Bodil Steen Rasmussen1,2 1Department of Clinical Medicine, Aalborg University, 2Department of Anaesthesia and Intensive Care, Aalborg University Hospital, 3Department of Health, Science and Technology, Aalborg University, Aalborg, 4Department of Respiratory Medicine, Aalborg University Hospital, Denmark Background: In general, previous studies have shown an association between prior exacerbations and mortality in COPD, but this association has not been demonstrated in the subpopulation of patients in need of assisted ventilation. We examined whether previous hospitalizations were independently associated with mortality among patients with COPD ventilated for the first time. Patients and methods: In the Danish National Patient Registry, we established a cohort of patients with COPD ventilated for the first time from 2003 to 2011 and previously medicated for obstructive airway diseases. We assessed the number of hospitalizations for COPD in the preceding year, age, sex, comorbidity, mode of ventilation, survival to discharge, and days to death beyond discharge. Results: The cohort consisted of 6,656 patients of whom 66% had not been hospitalized for COPD in the previous year, 18% once, 8% twice, and 9% thrice or more. In-hospital mortality was 45%, and of the patients alive at discharge, 11% died within a month and 39% within a year. In multivariate models, adjusted for age, sex, mode of ventilation, and comorbidity, odds ratios for in-hospital death were 1.26 (95% confidence interval [CI]: 1.11–1.44), 1.43 (95% CI: 1.19–1.72), and 1.56 (95% CI: 1.30–1.87) with one, two, and three or more hospitalizations, respectively. Hazard ratios for death after discharge from hospital were 1.32 (95% CI: 1.19–1.46), 1.76 (95% CI: 1.52–2.02), and 2.07 (95% CI: 1.80–2.38) with one, two, and three or more hospitalizations, respectively. Conclusion: Preceding hospitalizations for COPD are associated with in-hospital mortality and after discharge in the subpopulation of patients with COPD with acute exacerbation treated with assisted ventilation for the first time. Keywords: pulmonary disease, chronic obstructive, respiration, artificial, patient readmission, hospital mortality, critical carehttps://www.dovepress.com/assisted-ventilation-in-copd-ndash-association-between-previous-hospit-peer-reviewed-article-COPDPulmonary DiseaseChronic ObstructiveRespirationArtificialPatient ReadmissionHospital MortalityCritical Care |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Toft-Petersen AP Torp-Pedersen C Weinreich UM Rasmussen BS |
spellingShingle |
Toft-Petersen AP Torp-Pedersen C Weinreich UM Rasmussen BS Assisted ventilation in COPD – association between previous hospitalizations and mortality International Journal of COPD Pulmonary Disease Chronic Obstructive Respiration Artificial Patient Readmission Hospital Mortality Critical Care |
author_facet |
Toft-Petersen AP Torp-Pedersen C Weinreich UM Rasmussen BS |
author_sort |
Toft-Petersen AP |
title |
Assisted ventilation in COPD – association between previous hospitalizations and mortality |
title_short |
Assisted ventilation in COPD – association between previous hospitalizations and mortality |
title_full |
Assisted ventilation in COPD – association between previous hospitalizations and mortality |
title_fullStr |
Assisted ventilation in COPD – association between previous hospitalizations and mortality |
title_full_unstemmed |
Assisted ventilation in COPD – association between previous hospitalizations and mortality |
title_sort |
assisted ventilation in copd – association between previous hospitalizations and mortality |
publisher |
Dove Medical Press |
series |
International Journal of COPD |
issn |
1178-2005 |
publishDate |
2016-05-01 |
description |
Anne Pernille Toft-Petersen,1,2 Christian Torp-Pedersen,1,3 Ulla Møller Weinreich,1,4 Bodil Steen Rasmussen1,2 1Department of Clinical Medicine, Aalborg University, 2Department of Anaesthesia and Intensive Care, Aalborg University Hospital, 3Department of Health, Science and Technology, Aalborg University, Aalborg, 4Department of Respiratory Medicine, Aalborg University Hospital, Denmark Background: In general, previous studies have shown an association between prior exacerbations and mortality in COPD, but this association has not been demonstrated in the subpopulation of patients in need of assisted ventilation. We examined whether previous hospitalizations were independently associated with mortality among patients with COPD ventilated for the first time. Patients and methods: In the Danish National Patient Registry, we established a cohort of patients with COPD ventilated for the first time from 2003 to 2011 and previously medicated for obstructive airway diseases. We assessed the number of hospitalizations for COPD in the preceding year, age, sex, comorbidity, mode of ventilation, survival to discharge, and days to death beyond discharge. Results: The cohort consisted of 6,656 patients of whom 66% had not been hospitalized for COPD in the previous year, 18% once, 8% twice, and 9% thrice or more. In-hospital mortality was 45%, and of the patients alive at discharge, 11% died within a month and 39% within a year. In multivariate models, adjusted for age, sex, mode of ventilation, and comorbidity, odds ratios for in-hospital death were 1.26 (95% confidence interval [CI]: 1.11–1.44), 1.43 (95% CI: 1.19–1.72), and 1.56 (95% CI: 1.30–1.87) with one, two, and three or more hospitalizations, respectively. Hazard ratios for death after discharge from hospital were 1.32 (95% CI: 1.19–1.46), 1.76 (95% CI: 1.52–2.02), and 2.07 (95% CI: 1.80–2.38) with one, two, and three or more hospitalizations, respectively. Conclusion: Preceding hospitalizations for COPD are associated with in-hospital mortality and after discharge in the subpopulation of patients with COPD with acute exacerbation treated with assisted ventilation for the first time. Keywords: pulmonary disease, chronic obstructive, respiration, artificial, patient readmission, hospital mortality, critical care |
topic |
Pulmonary Disease Chronic Obstructive Respiration Artificial Patient Readmission Hospital Mortality Critical Care |
url |
https://www.dovepress.com/assisted-ventilation-in-copd-ndash-association-between-previous-hospit-peer-reviewed-article-COPD |
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