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[Risk factors for mortality in patients with chronic obstructive pulmonary disease]
Josep Montserrat-Capdevila1, Pere Godoy2, Josep Ramon Marsal3
1Institut de Recerca Biomèdica (IRB) Lleida, Lleida, España; Departament de Salut, Agència de Salut Pública de Catalunya, Lleida, España; CAP Mollerussa, Institut Català de la Salut (ICS), Mollerussa, España.
Objective:
To identify risk factors of mortality in patients with chronic obstructive pulmonary disease (COPD).
Design:
A retrospective cohort study.
Location:
Primary care setting in Lleida, Spain.
Participants:
2.501 patients older than 40 years with at least a spirometry in the 24 months prior to the beginning of the study were followed for 3 years.
Main Measurements:
The dependent variable was the overall mortality in the period 11/01/2010-10/31/2013; and the independents: spirometric parameters, severity (GOLD) and clinical variables. Their association with mortality was analyzed by calculating the adjusted odds ratio using a non-conditional logistic regression model.
Results:
The average age of 2.501 patients at the beginning of the study was 68.4 years (SD=11.6). 75.0% were males. 50.8% had a mild severity COPD, followed by moderate (35.3%), severe (9.4%) and very severe (4.4%). Mortality rate for the all period was 12.55%. The variables of the predictive model were: age, male sex, previous exacerbations, number of visits to primary care, comorbidity, smoking, severity of COPD (GOLD) and not receiving influenza vaccination, with an area under the ROC curve of 0.76.
Conclusions:
This model, easy and quick to apply, would identify those patients at increased risk of mortality and who could benefit from preventive strategies to improve their survival.
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