| Predicting end-of-life in patients with an exacerbation of COPD by routine clinical assessment. | |
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MedLine Citation:
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PMID: 20537518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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METHODS: In a case-crossover study the case records of AECOPD related deaths were reviewed. Clinical and laboratory variables including performance status (WHO-PS) and a composite physiological score (early warning score, EWS) at initial clinical assessment on final admission (FA) and penultimate admission (PA) for AECOPD were compared. RESULTS: Sixty patients included in study, female 60%, mean age (SD) 75 (8.7) years. 98% had ≥2 admissions for AECOPD. On univariate analysis variables associated with death were: Charlson score, WHO-PS, EWS, pH<7.35, Urea and CRP. On multivariate analysis predictors of mortality were: WHO-PS (OR 95% CI: 4.9 (1.06-22.61); p=0.04) and EWS (OR 95% CI: 3.39 (1.56-7.41); p=0.002). ROC analysis of relationship between combined WHO-PS/EWS score and death gave AUC 0.86; a total score≥6 had sensitivity 78% and specificity 86.2% and on multivariate analysis OR (95% CI) for death was 19.3 (4.3-86.2); p<0.0005. CONCLUSION: In-hospital deaths from AECOPD may be predicted by assessment of WHO-PS and EWS on admission to hospital. |
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Authors:
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Stephen A Murphy; Helmy Haja Mydin; Saman Fatah; George Antunes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Respiratory medicine Volume: 104 ISSN: 1532-3064 ISO Abbreviation: Respir Med Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-09-27 Completed Date: 2011-02-22 Revised Date: 2011-04-06 |
Medline Journal Info:
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Nlm Unique ID: 8908438 Medline TA: Respir Med Country: England |
Other Details:
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Languages: eng Pagination: 1668-74 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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University Hospital of Hartlepool, Hartlepool, UK. murphsa@clevelandchestclinic.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Disease Progression Female Great Britain / epidemiology Hospital Mortality / trends* Humans Life Expectancy / trends Male Patient Discharge / statistics & numerical data Prognosis Pulmonary Disease, Chronic Obstructive / epidemiology, mortality*, physiopathology ROC Curve Respiratory Insufficiency / epidemiology, mortality*, physiopathology Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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