Table 3.
Univariable and multivariable Poisson regression analyses of the association of baseline characteristics with mortality following COPD exacerbation (n=36,107)
| Baseline patient characteristics | Deaths, n (rate/1,000 person-years) | Crude rate ratio (95% CI) | P-valuea | Adjustedb rate ratio (95% CI) | P-valueb |
|---|---|---|---|---|---|
| Sex | |||||
| Male | 8,102 (151) | 1 (reference) | <0.001 | 1 (reference) | <0.001 |
| Female | 6,345 (131) | 0.87 (0.84, 0.90) | 0.87 (0.84, 0.90) | ||
| Age (years) | |||||
| <50 | 155 (35) | 1 (reference) | <0.001 | 1 (reference) | <0.001 |
| 50–59 | 910 (58) | 1.67 (1.41, 1.98) | 1.73 (1.46, 2.05) | ||
| 60–69 | 3,291 (103) | 2.97 (2.53, 3.49) | 3.21 (2.73, 3.77) | ||
| 70–79 | 5,831 (166) | 4.79 (4.08, 5.62) | 5.24 (4.45, 6.17) | ||
| 80–89 | 3,864 (274) | 7.88 (6.71, 9.25) | 8.37 (7.10, 9.88) | ||
| ≥90 | 396 (397) | 11.44 (9.50, 13.78) | 11.69 (9.66, 14.14) | ||
| Region | |||||
| London | 1,413 (132) | 1 (reference) | <0.001 | 1 (reference) | <0.001 |
| Midlands | 2,164 (146) | 1.11 (1.04, 1.19) | 1.13 (1.06, 1.21) | ||
| North England | 5,899 (144) | 1.09 (1.03, 1.16) | 1.09 (1.03, 1.15) | ||
| South England | 4,971 (139) | 1.05 (0.99, 1.12) | 1.13 (1.07, 1.20) | ||
| Acute kidney injury | 472 (512) | 3.71 (3.39, 4.07) | <0.001 | 2.47 (2.24, 3.73) | <0.001 |
| Body mass index | |||||
| Underweight | 751 (201) | 1.37 (1.27, 1.48) | <0.001 | 1.41 (1.30, 1.52) | <0.001 |
| Normal | 5,848 (147) | 1 (reference) | 1 (reference) | ||
| Overweight | 4,425 (127) | 0.86 (0.83, 0.90) | 0.82 (0.79, 0.85) | ||
| Moderately obese | 1,726 (118) | 0.80 (0.76, 0.85) | 0.83 (0.78, 0.87) | ||
| Severely obese | 478 (116) | 0.79 (0.72, 0.87) | 0.88 (0.80, 0.96) | ||
| Morbidly obese | 229 (112) | 0.76 (0.67, 0.87) | 0.99 (0.87, 1.13) | ||
| Missing | 990 (341) | – | – | ||
| COPD severity (GOLD stage) | |||||
| I | 886 (82) | 1 (reference) | <0.001 | 1 (reference) | <0.001 |
| II | 4,095 (99) | 1.21 (1.13, 1.30) | 1.18 (1.10, 1.27) | ||
| III | 3,983 (140) | 1.72 (2.14, 2.52) | 1.63 (1.52, 1.75) | ||
| IV | 1,580 (189) | 2.32 (2.14, 2.52) | 2.30 (2.11, 2.50) | ||
| Missing | 3,903 (295) | – | – | ||
| Hypertension | 7,654 (136) | 0.93 (0.90, 0.96) | <0.001 | 0.82 (0.79, 0.84) | <0.001 |
| Diabetes mellitus | 3,058 (122) | 0.83 (0.79, 0.86) | <0.001 | 0.84 (0.81, 0.87) | <0.001 |
| Angina | 3,199 (146) | 1.04 (1.00, 1.09) | 0.030 | 0.93 (0.90, 0.97) | <0.001 |
| Myocardial infarction | 2,613 (168) | 1.23 (1.18, 1.28) | <0.001 | 1.08 (1.03, 1.12) | <0.001 |
| Atrial fibrillation | 3,461 (171) | 1.27 (1.22, 1.32) | <0.001 | 1.00 (0.96, 1.04) | 0.844 |
| Heart failure | 4,394 (212) | 1.72 (1.66, 1.78) | <0.001 | 1.37 (1.32, 1.42) | <0.001 |
| Coronary artery bypass graft | 605 (127) | 0.89 (0.82, 0.97) | 0.007 | 0.85 (0.78, 0.92) | <0.001 |
| Pulmonary hypertension | 567 (207) | 1.49 (1.37, 1.62) | <0.001 | 1.46 (1.34, 1.59) | <0.001 |
| CKD (eGFR in mL/kg/1.73 m2) | |||||
| ≥90 | 1,741 (103) | 1 (reference) | <0.001 | 1 (reference) | <0.001 |
| ≥60 and <90 | 5,981 (114) | 1.14 (1.08, 1.20) | 0.70 (0.66, 0.74) | ||
| ≥30 and <60 | 5,763 (181) | 1.76 (1.67, 1.86) | 0.81 (0.76, 0.86) | ||
| ≥15 and <30 | 842 (360) | 3.50 (3.23, 3.80) | 1.42 (1.30, 1.55) | ||
| <15 | 120 (476) | 4.63 (3.85, 5.57) | 1.84 (1.67, 2.44) | ||
| COPD medications | 14,111 (139) | 0.45 (0.40, 0.50) | <0.001 | 0.54 (0.49, 0.60) | <0.001 |
| Antiplatelets | 9,421 (145) | 1.08 (1.04, 1.11) | <0.001 | 0.87 (0.84, 0.90) | <0.001 |
| Antidiabetes medications | 2,211 (125) | 0.87 (0.83, 0.91) | <0.001 | 0.92 (0.88, 0.96) | <0.001 |
| Beta blockers | 4,351 (132) | 0.91 (0.88, 0.94) | <0.001 | 0.89 (0.86, 0.92) | <0.001 |
| Diuretics | 11,744 (161) | 1.73 (1.66, 1.80) | <0.001 | 1.29 (1.24, 1.35) | <0.001 |
| ACEi/ARB | 7,959 (141) | 1.00 (0.97, 1.03) | 0.876 | 0.87 (0.84, 0.90) | <0.001 |
| Vasodilators | 439 (83) | 0.58 (0.52, 0.63) | <0.001 | 0.75 (0.68, 0.82) | <0.001 |
| Alpha blockers | 773 (160) | 1.14 (1.06, 1.22) | 0.001 | 0.99 (0.92, 1.06) | 0.730 |
| Inotropes | 3,036 (203) | 1.55 (1.49, 1.61) | <0.001 | 1.22 (1.17, 1.27) | <0.001 |
| Nitrates | 3,095 (148) | 1.06 (1.12, 1.11) | 0.002 | 1.00 (0.96, 1.04) | 0.961 |
| Calcium channel blockers | 5,091 (130) | 0.87 (0.85, 0.91) | <0.001 | 0.83 (0.80, 0.86) | <0.001 |
| Antiarrhythmic | 1,301 (139) | 0.66 (0.64, 0.68) | <0.001 | 0.68 (0.65, 0.70) | <0.001 |
| Anticoagulants | 3,156 (153) | 1.06 (1.02, 1.11) | 0.002 | 1.13 (1.08, 1.18) | <0.001 |
| Lipid lowering | 7,534 (118) | 0.87 (0.84, 0.91) | <0.001 | 0.91 (0.87, 0.95) | <0.001 |
| Time from exacerbation | |||||
| <6 months | 1 (reference) | <0.001 | 1 (reference) | <0.001 | |
| ≥6 months | 0.020 (0.19, 0.0.21) | 0.024 (0.023, 0.025) |
Notes:
a
Joint log likelihood test.
b
Adjusted for sex, age group, and eGFR.
Abbreviations: COPD, chronic obstructive pulmonary disease; CI, confidence interval; GOLD, Global initiative for chronic Obstructive Lung Disease; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; ACEi, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blocker.