COPD: exacerbations: readmissions were common

Clinical bottom line (level 2c)

  1. One in six patients admitted with a COPD exacerbation had carbon dioxide retention.
  2. 70% of patients were readmitted within the next 12 months.
  3. One in twelve patients died in hospital.
Gibson et al: Journal of Quality in Clinical Practice 1998; 18: 125-133
Expires November 2002

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: urban teaching hospital, Australia

128 patients (aged 50 to 89; mean 68, 62% male) admitted 248 times with exacerbations of COPD



Outcomes studied:
  • carbon dioxide retention
  • died in hospital
  • readmitted with COPD exacerbation within 12 months

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    carbon dioxide retention ? 46/248 19%
    (14% to 23%)    		 5
    (4 to 7)
    died in hospital 2 months 11/128 8.6%
    (3.7% to 13%)    		 12
    (7 to 27)
    readmitted with COPD exacerbation within 12 months 12 months 89/128 70%
    (62% to 78%)    		 1
    (1 to 2)

    Citation

    1. Gibson PG, Wlodarczyk JH, Wilson AJ, et al: severe exacerbations of chronic obstructive airways disease: health resource use in general practice and hospital. Journal of Quality in Clinical Practice 1998; 18: 125-133
    Search Terms: ?
    Contributor: Chris Ball & Clare Wotton, November 1999
    Reviewer: Santiago Alvarez Montero

    Clinical Question.
    Patient COPD
    Intervention or Exposure exacerbation
    Outcome death, readmission, carbon dioxide retention