[The impact of acute exacerbations of COPD on mortality]

The purpose of the study was to evaluate the impact of acute exacerbations of chronic obstructive pulmonary disease (COPD) on mortality and to identify the predictive factors in the Algerian population where COPD occurs as frequently as in the rest of the world.

An observational study of a cohort of 400 patients with an established diagnosis of COPD was performed in the pulmonology department of the University of Algiers. The patients were divided into two groups according to the number of exacerbations they experienced and were followed prospectively for 3 years. Mortality was analyzed comparatively in both groups.

During the follow-up period 39 patients died, mainly frequent exacerbators (84.6%), with a high mortality occurring during and in the months following hospitalisation (69.2%). By multivariate analysis the phenotype "frequent exacerbator" (RR=6.20; 95% CI: 2.6 to 14.8), GOLD category C (RR=7; 95% CI: 1.28 to 14.7), GOLD category D (RR=7.11; 95% CI: 1.38 to 15.6), age≥80 years (RR=2.7, 95% CI: 2.23 to 3.76) and chronic core pulmonale (RR=2.35; 95% CI 1.05 to 5.25) were shown to be independent risk factors of death.

The frequency and the severity of exacerbations impact negatively on the survival of patients with COPD.