COPD: half of elderly patients are dead within 7 years

Clinical bottom line (level 2c)

  1. Half of elderly patients discharged from hospital following a first admission for COPD are dead within 3 to 7 years.
Vilkman et al: Respiration 1997; 64: 281-284
Expires November 2003

The study

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

Setting: Finland

2237 patients (aged mean 67, 74% male) with a first admission to hospital with COPD, 1986 to 1990 (primary diagnosis from national hospital register)

Excluded if
  • aged < 65, > 69




    • ?100% followed for 3 to 7 years
    Outcomes studied:
  • death determined using national mortality register

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    death 3 to 7 years 1070/2237 48%
    (46% to 50%)

    Comments

    1. 37% died from cardiovascular causes, 30% from COPD, 12% from lung cancer and 8% from other cancers
    2. The conclusion of this study that COPD carries a poor prognosis, is supported by other studies as well (e.g. Lynn 2000)

    Citation

    1. Vilkman S, Keistinen T, Tuuponen T: survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital. Respiration 1997; 64: 281-284
    Search Terms:
    Contributor: Chris Ball and Clare Wotton, November 1999
    Reviewer: Eric Westman

    Clinical Question.
    Patient elderly
    Intervention or Exposure first admission to hospital with COPD
    Outcome death