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-ca
• dc.contributor.author Badenes Bonet, Diana, 1987-ca
• dc.contributor.author Martín-Ontiyuelo, Claraca
• dc.contributor.author Zuccarino, Flavioca
• dc.contributor.author Marín Corral, Judithca
• dc.contributor.author Rodríguez, Alejandroca
• dc.contributor.author Barreiro Portela, Estherca
• dc.contributor.author Gea Guiral, Joaquimca
• dc.date.accessioned 2017-12-22T12:35:58Z
• dc.date.available 2017-12-22T12:35:58Z
• dc.date.issued 2017
• 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/pdfca
• 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.doi http://dx.doi.org/10.2147/COPD.S129213
• dc.identifier.issn 1176-9106
• dc.identifier.uri http://hdl.handle.net/10230/33569
• dc.language.iso eng
• dc.publisher Dove Medical Pressca
• dc.relation.ispartof International Journal of Chronic Obstructive Pulmonary Disease. 2017 Jun 21;12:1837-45
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371
• 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.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc/3.0/
• dc.subject.keyword Vertebral fracture
• dc.subject.keyword COPD
• dc.subject.keyword Prognosis
• dc.subject.keyword Hospitalizations
• dc.title Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fracturesca
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion