The impact of comorbidities on the length of hospital treatment in patients with chronic obstructive pulmonary disease

Abstract

INTRODUCTION: The aim of this study was to assess relationships of chronic obstructive pulmonary disease (COPD)
comorbidities number, with the duration of hospital stay due to acute AE COPD in longitudinal prospective study.

MATERIAL AND METHODS: We evaluated the number of re-hospitalizations, length of stay and number of comorbidities in 464
consecutive COPD patients admitted to the tertiary respiratory hospital due to AE COPD enrolled in longitudinal prospective
study from 2005 to 2009 year.

RESULTS: GOLD II stage COPD patients had 4.1 ± 1.2 comorbidities (p = 0.002), stage III 3.4 ± 1.3 and stage IV had 3.6 ±
1.2 comorbidities. Duration of hospital stay (medians) was longer in more severe patients. Duration of hospitalization
correlated with urea level (r = 0.19 p < 0.001), pCO₂ (r = 0.193, p = 0.0003), HCO₃ (r = 0.25, p < 0.0001), haemoglobin
(r = –0.18, p < 0.001), and hematocrit (r = –0.13, p = 0.008). The patients with the risk of readmission had more severe
GOLD stage and were hypercapnic (pCO₂ = 47.6 mmHg v. 43.9 mmHg in those without hospitalization).

CONCLUSIONS: The haemoglobin level, hypercapnia and renal function are predictors of prolonged hospitalization. Patients
with more severe airflow limitation and higher pCO₂ have increased risk for readmission to the hospital. More severe disease
stage, clinical diagnosis of cor pulmonale or bronchiectasis was related to longer hospital stay.

Pneumonol. Alergol. Pol. 2011; 79, 6: 388–396