30-days mortality in patients admitted with COPD

Introduction: The aim of this study was to describe 30-days mortality after hospital admission for COPD. Methods: This is a retrospective study of all patients with the diagnosis of COPD as a primary diagnosis or co-diagnosis admitted to a tertiary pulmonary treatment unit, Department of Respiratory Medicine, Gentofte Hospital, Denmark in 2010. The 30-days mortality is compared to the Danish National Indicator Project (NIP). Results: 67 (15.1%) died out of 442 patients admitted with COPD within a period of 30-days after hospital admission, compared to 10% at the national level, odds ratio 1.51 (1.15 – 1.99). Mean age was 82.2 years, 55.2% were women and average BMI was 20.7. They had an average admission rate at 2.89 admissions in a period of 12 months prior to the inclusion date. Out of the 67, 23 (34.3%) received non-invasive ventilation (NIV) or respirator treatment at the respiratory unit or the intensive care unit. In 4 (5.9%) cases COPD was neither the cause of admission nor the cause of death, in further 18 (26.9%) cases COPD was not the cause of admission and 5 (7.5%) patients was wrongly diagnosed with COPD. Conclusion: The 30-days mortality is significantly higher at Department of Respiratory Medicine at Gentofte Hospital. Possible explanations are a selection of hospitalization of more severe cases of COPD since the department has a unique outgoing COPD-treatment unit, which treats the milder exacerbations at home. Furthermore a mortality increase due to a selection of high risk patients with complications, comorbidities and pulmonary cancer in a tertiary unit. In conclusion, the crude 30-days mortality needs further data interpretation if to be used as a measurement for quality of treatment for patients admitted with COPD.