One cohort study [14] has shown that predictors of increased mortality in COPD include:

  • Increasing age
  • Significant co-morbidity
  • Decreasing post bronchodilator FEV1
  • Those patients already on long term oxygen therapy
  • Increased number of COPD exacerbations, particularly those with 3 or more episodes
  • Increased number of hospital admissions

A further UK audit [15] has shown death in 14% of patients admitted to hospital within 3 months of admission. The most important prognosticators for death in this group were:

  • Poor performance status*
  • Low arterial pH on admission*
  • Presence of bilateral leg oedema*
  • Age > 70 years
  • Home circumstances, particularly if the patient is in a nursing home
  • Unrecordable peak flow on admission
  • Pulse oximetry showing oxygen saturation under 86%
  • Intervention with assisted ventilation

The 3 marked with * were the 3 major independent predictors of mortality.

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