S. Vilkman et al., SURVIVAL AND CAUSE OF DEATH AMONG ELDERLY CHRONIC OBSTRUCTIVE PULMONARY-DISEASE PATIENTS AFTER FIRST ADMISSION TO HOSPITAL, Respiration, 64(4), 1997, pp. 281-284
Those patients with chronic obstructive pulmonary disease (COPD) who r
equire hospital treatment are severely ill. We have studied the surviv
al and cause of death among COPD patients in Finland after their first
admission to hospital due to COPD. COPD-related treatment periods in
all hospitals during 1972-1992 were collected from the national discha
rge register, and a subgroup was defined consisting of 2,237 patients
aged 65-69 years who had their first admission during 1986-1990. Survi
val and causes of death were analysed for this group using the data co
ntained in the national mortality statistics. The mortality data were
recorded up to the end of 1993. By the end of 1993, 1,070 persons (48%
) in the study group had died. The median survival time was 5.71 years
(95% CI 5.27-6.15). Female COPD patients had a more favourable progno
sis than males. COPD had been certified as the main cause of death for
33.3% of the women and 29.4% of the men. The proportion of COPD as ma
in cause of death increased with an increasing number of treatment per
iods prior to death. In conclusion, the first hospital admission for C
OPD indicates a poor prognosis. A high incidence of pulmonary cancer c
ontributes to the poor outcome in the case of men. COPD is obviously u
nderrated on death certificates as the cause of death among COPD patie
nts.