PT  - JOURNAL ARTICLE
AU  - Amir Soltani
AU  - David Reid
AU  - Steve Quinn
AU  - Ian Almond
AU  - Richard Wood-Baker
AU  - E. Haydn Walters
TI  - Predictors of hospitalisation and death with acute exacerbations of COPD
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 404
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/404.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/404.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Background: Acute exacerbations of COPD (AECOPD) are common causes of attendance to hospital emergency department (ED), but there are limited data on decision making about hospitalisation.Aims: To analyse decision making for hospitalisation and predictors of death in patients attended with AECOPD in a public hospital in Australia.Methods: All patients with a diagnosis of AECOPD attending the ED of the Royal Hobart Hospital between November 2006 and July 2008 (21 months) were reviewed. Patients who were admitted to the hospital were compared with those who were discharged home. Survival analysis was used to find predictors of death.Results: 150 patients with 218 admissions (50% female, 42% current- and 58% ex-smokers, 24% with history of heart disease and 5% with previous history of myocardial infarction) were included in the study.Those discharged from ED had a lower heart rate/minute than those admitted [mean (SD) 96 (17) vs. 105 (19), p<0.01] but there were no other differences. Age (HR=1.07, p<0.02), being female (HR=0.3, P<0.04) (female =0 and male=1), having a past history of myocardial infarction (HR=53.6, p<0.001), hypercapnia (HR=1.04, p<0.003) and co-presence of heart disease (HR=5.7, p<0.03) were the significant predictors of death during the period of the study.Conclusions: Decision making for hospitalisation of patients in the ED seems largely arbitrary. Cardiac disease was the strongest predictor of death.