@article {Piquet946, author = {Jacques Piquet and Jean-Michel Chavaillon and Philippe David and Francis Martin and Fran{\c c}ois Blanchon and Nicolas Roche}, editor = {,}, title = {High-risk patients following hospitalisation for an acute exacerbation of COPD}, volume = {42}, number = {4}, pages = {946--955}, year = {2013}, doi = {10.1183/09031936.00180312}, publisher = {European Respiratory Society}, abstract = {The aim of this study was to assess long-term mortality and predictive factors of death after hospital admission for acute exacerbation of chronic obstructive pulmonary disease (COPD).1824 patients (23.2\% female; mean age 70.3{\textpm}11.3 years) consecutively admitted for acute exacerbation of COPD in the respiratory medicine departments of 68 general hospitals between October 2006 and June 2007 were prospectively enrolled in a follow-up cohort. Their vital status was documented between October 2010 and April 2011.Vital status was available for 1750 patients (95.9\%), among whom 787 (45\%) died during follow-up. Multivariate analysis found that age (60{\textendash}80 years and >=80 years versus \<60 years, relative risk 2.99, 95\% CI 2.31{\textendash}3.89), lower body mass index (25{\textendash}30 kg{\textperiodcentered}m-2 versus <=20 kg{\textperiodcentered}m-2, relative risk 0.80, 95\% CI 0.66{\textendash}0.97), lung cancer (relative risk 2.08, 95\% CI 1.43{\textendash}3.01), cardiovascular comorbidity (relative risk 1.35, 95\% CI 1.16{\textendash}1.58), previous hospital admissions for acute exacerbation of COPD (four or more versus none, relative risk 1.91, 95\% CI 1.44{\textendash}2.53), use of accessory respiratory muscles (relative risk 1.19, 95\% CI 1.01{\textendash}1.40) or lower-limb oedema (relative risk 1.74, 95\% CI (1.44{\textendash}2.12)) at admission and treatment by long-term oxygen therapy at discharge (relative risk 2.09, 95\% CI 1.79{\textendash}2.45) were independent risk factors of death.Mortality rate during the 4 years following hospital admission for acute exacerbation of COPD was high (45\%). Simple clinical information relating to respiratory and general status can help in identifying high-risk patients and targeting more intensive follow-up and care. Interestingly, cardiovascular comorbidities and past hospitalisations for acute exacerbation of COPD, but not forced expiratory volume in 1 s, independently predicted the risk of death.Long-term risk of death after hospitalisation for acute exacerbation of COPD is high but can be readily identified http://ow.ly/li4GZ}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/4/946}, eprint = {https://erj.ersjournals.com/content/42/4/946.full.pdf}, journal = {European Respiratory Journal} }