Analysis Of The Influencing Factors Of Five-year Survival In Patients With Severe Exacerbations Of COPD Requiring Hospitalization

Objective: We analyzed the influencing factors of five-year survival in patients with severe exacerbations of chronic obstructive pulmonary disease(COPD).We concentrated on the effect of exacerbation frequencies on prognosis.Methods: A cohort study was conducted in 518 patients with severe exacerbations of COPD hospitalized in our hospital from January 2007 to December 2011.Patients were followed until death or five years since entry of the study.The survival rate was calculated by Life Tables method and the survival curve was drawn.Univariate Cox proportional hazards model was used to analyze the influencing factors of five-year survival.Analyze the mortality and exacerbations in the next year of patients with different frequencies of exacerbations.Results: The 1-year mortality rate of patients with severe exacerbations of COPD was 15.64%,the 3-year mortality rate was 25.68%,and the 5-year mortality rate was 35.26%.Age,respiratory failure and cardiovascular complication were the influencing factors of five-year survival.Patients over 70 years of age had higher mortality rate with the risk of death 1.857 times greater than patients less than 70 years of age.Patients with respiratory failure had higher mortality rate with the risk of death 235.614 times greater than patients without respiratory failure.Patients with cardiovascular complication had higher mortality rate with the risk of death 2.293 times greater than patients without cardiovascular complication.Patients with ≥2 acute exacerbations had higher mortality rate in the next year than patients with 0 or 1 acute exacerbations.Patients with ≥2 acute exacerbations had higher rate of acute exacerbations in the next year than patients with 0 or 1 acute exacerbation.Patients with ≥2 acute exacerbations had higher rate of ≥2 acute exacerbations in the next year than patients with 0 or 1 acute exacerbation.Conclusions:1.The patients with severe exacerbations of COPD requiring hospitalization have a poor prognosis with the 5-year mortality rate of 35.26%.2.Advanced age,respiratory failure and cardiovascular complication are the risk factors of five-year survival in patients with severe exacerbations of COPD.3.Frequent exacerbators are more likely to have a higher mortality rate than infrequent exacerbators.4.Frequent exacerbators are more likely to have a higher rate of exacerbations and frequent exacerbations in the next year than infrequent exacerbators.