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Related Experiment Videos

One-year mortality in elderly stable patients with COPD.

P Ranieri1, R Rozzini, S Franzoni

  • 1Geriatric Evaluation and Rehabilitation Unit, Paolo Richiedei Hospital Gussago, Brescia.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|May 1, 2002
PubMed
Summary

Very old hospitalized patients with chronic obstructive pulmonary disease (COPD) and functional impairment face double the one-year mortality risk. Cor pulmonale further quadruples this risk, highlighting the need for targeted interventions.

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Area of Science:

  • Geriatrics
  • Pulmonology
  • Public Health

Background:

  • Hospitalized very old patients, including those with chronic obstructive pulmonary disease (COPD), have varying mortality risks.
  • Comprehensive geriatric assessment is crucial for evaluating outcomes in elderly populations.

Purpose of the Study:

  • To evaluate the one-year mortality risk in very old hospitalized patients, comparing those with and without COPD.
  • To identify specific factors, including disease severity and comorbidities, that influence mortality in this demographic.

Main Methods:

  • A retrospective study of 658 disabled patients discharged from a Geriatric Evaluation and Rehabilitation Unit (GERU).
  • Patients were categorized into COPD (n=337) and non-COPD (n=321) groups.
  • Multidimensional assessments included demographics, cognitive status (MMSE), physical health (IDS, drug use), functional disability (BADL, Tinetti, PPT), and nutritional status (PNI). Survival was tracked for one year post-discharge.

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Main Results:

  • COPD patients were older, more likely smokers, and had more comorbidities and drug use.
  • Patients with functional impairment (IDS 2-4) had double the one-year mortality risk compared to symptomatic COPD (IDS 1) or non-COPD (IDS 0) groups, after adjustments.
  • COPD patients with cor pulmonale (CP) and functional impairment (IDS 2-4) faced a fourfold increased mortality risk versus the IDS 1 COPD group, adjusted for covariates.

Conclusions:

  • Hospitalized very old COPD patients with functional impairment have a significantly higher one-year mortality risk.
  • The presence of cor pulmonale in functionally impaired COPD patients substantially elevates mortality risk.
  • These findings underscore the importance of assessing functional status and comorbidities in elderly COPD patients for risk stratification.