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Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments).

Publication ,  Journal Article
Connors, AF; Dawson, NV; Thomas, C; Harrell, FE; Desbiens, N; Fulkerson, WJ; Kussin, P; Bellamy, P; Goldman, L; Knaus, WA
Published in: Am J Respir Crit Care Med
October 1996

In order to describe the outcomes of patients hospitalized with an acute exacerbation of severe chronic obstructive pulmonary disease (COPD) and determine the relationship between patient characteristics and length of survival, we studied a prospective cohort of 1,016 adult patients from five hospitals who were admitted with an exacerbation of COPD and a PaCO2 of 50 mm Hg or more. Patient characteristics and acute physiology were determined. Outcomes were evaluated over a 6 mo period. Although only 11% of the patients died during the index hospital stay, the 60-d, 180-d, 1-yr, and 2-yr mortality was high (20%, 33%, 43%, and 49%, respectively). The median cost of the index hospital stay was $7,100 ($4,100 to $16,000; interquartile range). The median length of the index hospital stay was 9 d (5 to 15 d). After discharge, 446 patients were readmitted 754 times in the next 6 mo. At 6 mo, only 26% of the cohort were both alive and able to report a good, very good, or excellent quality of life. Survival time was independently related to severity of illness, body mass index (BMI), age, prior functional status, PaO2/FI(O2), congestive heart failure, serum albumin, and the presence of cor pulmonale. Patients and caregivers should be aware of the likelihood of poor outcomes following hospitalization for exacerbation of COPD associated with hypercarbia.

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Published In

Am J Respir Crit Care Med

DOI

ISSN

1073-449X

Publication Date

October 1996

Volume

154

Issue

4 Pt 1

Start / End Page

959 / 967

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Survival Analysis
  • Respiratory System
  • Prospective Studies
  • Prognosis
  • Patient Readmission
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Connors, A. F., Dawson, N. V., Thomas, C., Harrell, F. E., Desbiens, N., Fulkerson, W. J., … Knaus, W. A. (1996). Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med, 154(4 Pt 1), 959–967. https://doi.org/10.1164/ajrccm.154.4.8887592
Connors, A. F., N. V. Dawson, C. Thomas, F. E. Harrell, N. Desbiens, W. J. Fulkerson, P. Kussin, P. Bellamy, L. Goldman, and W. A. Knaus. “Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments).Am J Respir Crit Care Med 154, no. 4 Pt 1 (October 1996): 959–67. https://doi.org/10.1164/ajrccm.154.4.8887592.
Connors AF, Dawson NV, Thomas C, Harrell FE, Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):959–67.
Connors, A. F., et al. “Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments).Am J Respir Crit Care Med, vol. 154, no. 4 Pt 1, Oct. 1996, pp. 959–67. Pubmed, doi:10.1164/ajrccm.154.4.8887592.
Connors AF, Dawson NV, Thomas C, Harrell FE, Desbiens N, Fulkerson WJ, Kussin P, Bellamy P, Goldman L, Knaus WA. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):959–967.

Published In

Am J Respir Crit Care Med

DOI

ISSN

1073-449X

Publication Date

October 1996

Volume

154

Issue

4 Pt 1

Start / End Page

959 / 967

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Survival Analysis
  • Respiratory System
  • Prospective Studies
  • Prognosis
  • Patient Readmission
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male