Overweight is a Predictor of Long-term Survival in Hospitalised Patients with Exacerbations of COPD

Background: Although hospitalisations due to an exacerbation of chronic obstructive pulmonary disease (COPD) are associated with increased risk of mortality, there is little information on long-term survival after severe COPD exacerbations.

Methods: The 5-year and 8-year overall survival after hospitalisation due to a COPD exacerbation was explored. In addition, potential predictors of survival were analysed.

Results: The 57 patients with COPD included in this analysis had a median age of 70 years, a median smoking history of 30 pack years and a median forced expiratory volume in the first second (FEV1) of 41.6% predicted at the time of COPD exacerbation. The majority of the patients had either normal weight (body mass index, BMI 18.5-24.99 kg/m(2): 42%) or overweight (BMI ≥ 25 kg/m(2): 54%). The 5-year overall survival after exacerbation was 54%, the 8-year overall survival 42%. The presence of cardiac comorbidities, a FEV1 <50% predicted, an age >70 years and a BMI <25 kg/m(2), but not smoking history or current smoking, were associated with decreased overall survival. Multivariate regression analysis revealed that only BMI, age and FEV1 were independent predictors of long-term survival. Overweight patients (BMI ≥ 25 kg/m(2)) had a substantially higher 5-year overall survival (74%) than patients with a BMI < 25 kg/m(2) (31%).

Conclusion: Nearly half of the patients hospitalised due to an exacerbation of COPD die within 5 years after the event. Overweight is a positive predictor of long-term survival in these patients.