15-Year mortality after hospitalization for COPD in a Dutch teaching hospital: Preliminary data from the MORTCOP cohort

Background: Most COPD-survival studies have examined either 5 or occasionally 10-year survival. Here, we investigate 15-year survival after an admission for exacerbation of COPD. Knowledge of long term survival and its prognostic factors may lead to improvement in care and better life expectancy. Methods: The study was performed at a 651-bed teaching hospital in a former coal mining area in the Netherlands. From 1996 to 1999, patients admitted with an exacerbation COPD were included (MORTCOP cohort). Results: Out of 666 patients, 59 (8.9%) were alive after 15 years. Survival for GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage I-IV was respectively 27.1, 13.9, 8.5 and 0.9% (p<0.05; see figure). Other factors significantly related to 15-year survival were (Cox proportional hazard ratio): age >65 (2.7), body mass index < 20 (1.4), transfer factor of the lung for carbon monoxide < 80% of predicted value (1.8), and previous admission (1.5). Death was caused by COPD (54%), cardiovascular disease (16%), lung carcinoma (4%) or other (18%). Death due to COPD was 18% versus 71% among GOLD I and IV patients. Life expectancy is substantially lower in our cohort than in the general Dutch population (www.nationaalkompas.nl/gezondheid-en-ziekte). Conclusion: In our cohort, the 15-year survival among COPD patients following an admission for exacerbation is only 8.9%.