Implications of frailty in COPD exacerbations

Authors

Aimee Almanzar, HCA HealthcareFollow
Armando Cabrera, HCA HealthcareFollow
Felix Hernandez
Hector Y. Vazquez, HCA HealthcareFollow
Asma Jafri, Aventura Hospital and Medical Center
Miriam Zylberglait Lisigurski, HCA HealthcareFollow
Livasky Concepcion, HCA HealthcareFollow
Gustavo Ferrer, HCA HealthcareFollow

Division

East Florida

Hospital

Aventura Hospital and Medical Center

Document Type

Presentation

Publication Date

10-20-2019

Keywords

COPD, frailty, geriatric conditions, patient outcomes, retrospective studies

Disciplines

Critical Care | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Pulmonology

Abstract

Introduction The extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) patients are similar to symptoms of frailty, a geriatric syndrome. This study was designed to identify the relation between frailty and patient outcomes during a COPD exacerbation. Methods This retrospective study identified 10,235 patients hospitalized for COPD exacerbation, as well as 16 laboratory tests included in a frailty index that have been linked to frailty. Patients were divided into less frail (0-8 positive laboratory values) and more frail (9-16 positive laboratory values) groups. The primary composite endpoints were mechanical ventilation, ICU length of stay, readmission, and discharge status. Results Of the 10,235 patients in this study, 205 (2%) classified as more frail. These patients were 6.3 times more likely to need MV (SDD 0.000). If they were admitted to the ICU, they spent 29 hours longer (SDD 0.002) than the less frail group. The more frail group was discharged to hospice or expired (35.2% vs. 3.5%), home (40.6% vs. 74.4%), acute/subacute rehabilitation (16.8% vs. 13.8%), compared to the less frail group. There was no statistical difference between high risk of frailty and less frail in terms of hospital readmissions (SD 0.604) or having pulmonary service consulted during the hospital admission (SDD 0.398). Conclusion We found that highly frail patients have poorer outcomes than their less frail counterparts including longer ICU length of stay and less possibility of discharge home from the hospital. Interestingly, there was no statistical significance in terms of hospital readmissions.

Publisher or Conference

American College of Chest Physicians Annual Meeting

Recommended Citation

Almanzar A, et al. Implications of Frailty in COPD Exacerbations. Paper presented at: American College of Chest Physicians Annual Meeting; October 19-23, 2019; New Orleans, LA.