2006 OPEN FORUM Abstracts
MORTALITY PREDICTORS FOR HOSPITAL ADMISSIONS FOR COPD
A Asiimwe PhD Research Fellow1,2, D Prytherch PhD1,2, S Kilburn PhD2, AJ Chauhan PhD1, B Higgins BSc2,
Queen
Alexandra Hospital, Portsmouth1; Dept of Health Sciences,
University of Portsmouth, Portsmouth UK.2
Several
factors including co-morbidity, severity of airflow obstruction and previous
hospitalisation are known to reduce survival following admissions for acute
exacerbations of COPD (AECOPD). We
examined whether routinely collected data could
predict mortality at admission, 30 days and 1 year after discharge and if we
could construct (and later test) models of risk of death for people admitted to
Portsmouth Hospitals NHS Trust for AECOPD.
Methods: We
examined 22,614 COPD admissions from 12,950 patients (ICD codes 10th version
ranging from J40 to J44) from 1996-2005.
Clinical data were recorded immediately on admission. Generalised estimating equations (XTGEE
procedure, STATA 8) allowing
for lack of independence of admissions were used to construct regression models for risk of death, using
routinely available biochemical and haematological
data, gender and age.
Results: The
range of admissions per patient were: 1(70.1%), 2(15.7%), 3(8.2%), and
≥4(12.4%). Mortality for
in-patients, at 30-day and 1-year were 1216(9.4%), 1417(10.9%) and 1883(14.5%)
respectively. We identified
age(p=0.001), pCO2 (p=0.000),
and serum urea(P=0.000) as significant predictors of mortality at each time
point.
Conclusion: Effective models of
mortality applicable to all COPD admissions could be constructed from routine
clinical data, obtained largely from two venesections
on admission.