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Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures

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dc.contributor.author Pascual Guàrdia, Sergi, 1979-
dc.contributor.author Badenes Bonet, Diana, 1987-
dc.contributor.author Martín-Ontiyuelo, Clara
dc.contributor.author Zuccarino, Flavio
dc.contributor.author Marín Corral, Judith
dc.contributor.author Rodríguez, Alejandro
dc.contributor.author Barreiro Portela, Esther
dc.contributor.author Gea Guiral, Joaquim
dc.date.accessioned 2017-12-22T12:35:58Z
dc.date.available 2017-12-22T12:35:58Z
dc.date.issued 2017
dc.identifier.citation Pascual-Guardia S, Badenes-Bonet D, Martin-Ontiyuelo C, Zuccarino F, Marín-Corral J, Rodríguez A et al. Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures. Int J Chron Obstruct Pulmon Dis. 2017 Jun 21;12:1837-45. DOI: 10.2147/COPD.S129213
dc.identifier.issn 1176-9106
dc.identifier.uri http://hdl.handle.net/10230/33569
dc.description.abstract BACKGROUND: Vertebral compression fractures (VCF) are common in COPD patients, with osteoporosis being the main cause. The clinical impact of VCF derives mostly from both pain and chest deformity, which may lead to ventilatory and physical activity limitations. Surprisingly, the consequences of VCF on the quality outcomes of hospital care are poorly known. OBJECTIVE: To assess these indicators in patients hospitalized due to a COPD exacerbation (ECOPD) who also have VCF. METHODS: Clinical characteristics and quality care indicators were assessed in two one-year periods, one retrospective (exploratory) and one prospective (validation), in all consecutive patients hospitalized for ECOPD. Diagnosis of VCF was based on the reduction of >20% height of the vertebral body evaluated in standard lateral chest X-ray (three independent observers). RESULTS: From the 248 patients admitted during the exploratory phase, a third had at least one VCF. Underdiagnosis rate was 97.6%, and patients with VCF had more admissions (normalized for survival), longer hospital stays, and higher mortality than patients without (4 [25th-75th percentiles, 2-8] vs 3 [1-6] admissions, P<0.01; 12 [6-30] vs 9 [6-18] days, P<0.05; and 50 vs 32.1% deaths, P<0.01, respectively). The risk of dying in the two following years was also higher in VCF patients (odds ratio: 2.11 [1.2-3.6], P<0.01). The validation cohort consisted of 250 patients who showed very similar results. The logistic regression analysis indicated that both VCF and age were factors independently associated with mortality. CONCLUSION: Although VCF is frequently underdiagnosed in patients hospitalized for ECOPD, it is strongly associated with a worse prognosis and quality care outcomes.
dc.description.sponsorship This study has been partially funded by SEPAR (264/2012), CIBERES, FIS (12/02534), Plan Nacional I+D+i (SAF-2014 – 54371), Generalitat de Catalunya (2009-SGR-393), and FUCAP (2012).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Dove Medical Press
dc.relation.ispartof International Journal of Chronic Obstructive Pulmonary Disease. 2017 Jun 21;12:1837-45
dc.rights © 2017 Pascual-Guardia et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
dc.rights.uri http://creativecommons.org/licenses/by-nc/3.0/
dc.title Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.2147/COPD.S129213
dc.subject.keyword Vertebral fracture
dc.subject.keyword COPD
dc.subject.keyword Prognosis
dc.subject.keyword Hospitalizations
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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