Predictors of Mortality in Hospitalized Adults with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. A Systematic Review and Meta-analysis

This paper aims to systematically review the literature to identify clinically important factors that predict mortality after hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD). Eligible studies considered adults admitted to hospital with COPD exacerbation. Two authors independently abstracted data. Odds ratios were then calculated by comparing the prevalence of each predictor in survivors versus nonsurvivors. There were 37 studies included with risk of death ranging from 3.6% for studies considering short-term mortality, 31% for long-term mortality, and 29% for studies that considered solely intensive care unit (ICU)-admitted study subjects. Twelve prognostic factors (age, male sex, low bodymass index, cardiac failure, chronic renal failure, confusion, long-term oxygen therapy, lower limb edema, Global Initiative for Chronic Lung Disease criteria stage 4, cor pulmonale, acidemia, and elevated plasma troponin level) were significantly associated with increased short-term mortality. Different factors correlate with mortality from COPD exacerbation in the short term, long term, and after ICU admission.