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

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...

Descripción completa

Detalles Bibliográficos
Autores: Pascual Guàrdia, Sergi, 1979-, Badenes Bonet, Diana, 1987-, Martín-Ontiyuelo, Clara, Zuccarino, Flavio, Marín Corral, Judith, Rodríguez, Alejandro, Barreiro Portela, Esther, Gea Guiral, Joaquim
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/33569
Acceso en línea:http://hdl.handle.net/10230/33569
http://dx.doi.org/10.2147/COPD.S129213
Access Level:acceso abierto
Palabra clave:Vertebral fracture
COPD
Prognosis
Hospitalizations
id ES_1127c5c19ac92dedfd63634a5b5eecb9
oai_identifier_str oai:repositori.upf.edu:10230/33569
network_acronym_str ES
network_name_str España
repository_id_str
spelling Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fracturesPascual Guàrdia, Sergi, 1979-Badenes Bonet, Diana, 1987-Martín-Ontiyuelo, ClaraZuccarino, FlavioMarín Corral, JudithRodríguez, AlejandroBarreiro Portela, EstherGea Guiral, JoaquimVertebral fractureCOPDPrognosisHospitalizationsBACKGROUND: 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.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).Dove Medical Press201720172017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/33569http://dx.doi.org/10.2147/COPD.S129213reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésInternational Journal of Chronic Obstructive Pulmonary Disease. 2017 Jun 21;12:1837-45info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371© 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).http://creativecommons.org/licenses/by-nc/3.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/335692026-06-12T07:21:37Z
dc.title.none.fl_str_mv Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
title Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
spellingShingle Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
Pascual Guàrdia, Sergi, 1979-
Vertebral fracture
COPD
Prognosis
Hospitalizations
title_short Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
title_full Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
title_fullStr Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
title_full_unstemmed Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
title_sort Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures
dc.creator.none.fl_str_mv Pascual Guàrdia, Sergi, 1979-
Badenes Bonet, Diana, 1987-
Martín-Ontiyuelo, Clara
Zuccarino, Flavio
Marín Corral, Judith
Rodríguez, Alejandro
Barreiro Portela, Esther
Gea Guiral, Joaquim
author Pascual Guàrdia, Sergi, 1979-
author_facet Pascual Guàrdia, Sergi, 1979-
Badenes Bonet, Diana, 1987-
Martín-Ontiyuelo, Clara
Zuccarino, Flavio
Marín Corral, Judith
Rodríguez, Alejandro
Barreiro Portela, Esther
Gea Guiral, Joaquim
author_role author
author2 Badenes Bonet, Diana, 1987-
Martín-Ontiyuelo, Clara
Zuccarino, Flavio
Marín Corral, Judith
Rodríguez, Alejandro
Barreiro Portela, Esther
Gea Guiral, Joaquim
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Vertebral fracture
COPD
Prognosis
Hospitalizations
topic Vertebral fracture
COPD
Prognosis
Hospitalizations
description 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.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017
2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/33569
http://dx.doi.org/10.2147/COPD.S129213
url http://hdl.handle.net/10230/33569
http://dx.doi.org/10.2147/COPD.S129213
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Chronic Obstructive Pulmonary Disease. 2017 Jun 21;12:1837-45
info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/3.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/3.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Dove Medical Press
publisher.none.fl_str_mv Dove Medical Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869403549505421312
score 15,81155

Similares en LA Referencia