Mortality rate during exacerbation episodes of Chronic Obstructive Pulmonary Disease (COPD) in elderly individuals hospitalized at a university institution in the State of Paraná, Brazil




Chronic obstructive pulmonary disease; Elderly; Hospital mortality; Exacerbation of symptoms; Electronic health records.


Acute exacerbations (AECOPD) of COPD negatively impact health status, hospitalization rates, disease progression and health system costs, and other acute events can mimic or worsen AECOPD, which can lead to diagnostic difficulties, especially in elderly patients with multiple associated comorbidities. Advanced age is an isolated risk factor and corresponds to the median age of patients with more severe stages of the disease, therefore, early identification of patients at risk of hospital mortality is crucial. Observational, retrospective, quantitative study, approved by CEP/CAAE 63850022.8.0000.0107. Data were collected from electronic medical records between March/2019 and February/2023, from patients aged ≥60 years with ICD-10 J44 and an active search for medical records of patients with a diagnostic hypothesis of AECOPD with other ICD classifications. They admitted 169 patients with a diagnostic hypothesis of AECOPD in medical evolution, many with other ICD-10 (among them J96, J15, J18, B342, R060) that may be related to AECOPD. Mortality (n=169) was 46.15%. In total, 59 patients with ICD-10 J44 characterized the sample, with a mortality rate of 37.5%. The mortality of patients with AECOPD ˃60 years of age is high, with high urea, LA and CRP on admission being predisposing factors. The present study aimed to analyze clinical factors related to mortality in elderly patients aged 60 or over, hospitalized in an educational institution linked to the Unified Health System (SUS) due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD), and evaluated the existence of possible cases of underdiagnosis among patients.


Terry, P. D. & Dhand, R. (2023). The 2023 GOLD Report: Updated Guidelines for Inhaled Pharmacological Therapy in Patients with Stable COPD. Pulm Ther.

Prediletto, I., Giancotti, G. & Nava, S. (2023). COPD Exacerbation: Why It Is Important to Avoid ICU Admission. J. Clin. Med. 12, 3369.

Jörg D. Leuppi, Pierre-Olivier Bridevaux, Florian Charbonnier, & Christian F. (2023) Clarenbach, Hans-Werner Duchna, Jean-Marc Fellrath, Pietro Gianella, Anja Jochmann, Lukas Kern, Nikolay Pavlov, Thomas Rothe, Claudia Steurer-Stey, and Christophe von Garnier Praxis 112(7-8), 403-412.

Karkra, R., Krishnarao, C. S., Siddaiah, J. B., & Anand, M. P. (2023) Hematological Parameters for Predicting Mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. J. Clin. Med., 12, 4227.

Santoro, C. M., Dantas, A. C. A., de Oliveira, D. V., & Ferreira, E. G. (2023). Mortalidade hospitalar no sistema único de saúde por DPOC pré e durante a pandemia da COVID-19 no estado do Paraná. Cuadernos De Educación Y Desarrollo, 15(12), 15871–15890.

Agustí, A., Celli, B. R., Criner, G. J., Halpin, D., Anzueto, A., Barnes, P., et al. (2023) Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. Am J Respir Crit Care Med. 207(7), 819-837.

Zhang, J., Qin, Y., Zhou, C., Luo, Y., Wei, H., Ge, H., et al. (2023) Elevated BUN Upon Admission as a Predictor of In-Hospital Mortality Among Patients with Acute Exacerbation of COPD: A Secondary Analysis of Multicenter Cohort Study. Int J Chron Obstruct Pulmon Dis. 18, 1445-1455.

Feng, X., Xiao, H., Duan, Y., Li, Q., & Ou, X. (2023) Prognostic Value of Neutrophil to Lymphocyte Ratio for Predicting 90-Day Poor Outcomes in Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis.18:1219-1230.

Singh, B., Kampani, G., Lall, B., & Singh, M. (2022) Study of Inflammatory Markers in Chronic Obstructive Pulmonary Disease. J Assoc Physicians India. 70(12):11-12. 10.5005/japi- 11001-0165.

Kwok, W. C., Chau, C. H., Tam, T. C. C., Lam, F. M., & Ho, J. C. M. (2023) Variability of Blood Eosinophil Count at Stable-State in Predicting Exacerbation Risk of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis; 18, 1145-1153

Ayres, L., Cruz, S., Pinhero, M., Gomes, A., Nascimento, L., & Oliveira, T. (2020) Avaliação clínica da gravidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC) atendidos no CEMEC–CESUPA. Braz. J. Hea. Rev. 3 (5), 12096-115

Mota, J. C., Santos, M. R., Sousa, L. R., Abdoral, P. R. G., Abdoral, L. R. S., & Miranda, C. J. C. P. (2023) Inspiratory muscle training in people with chronic obstructive pulmonary disease (COPD): a systematic review. Fisioter Pesqui. 30, e21028823pt

Lu, L., Chen, M., Xing, X., Liu, X., Wei, X., Wang, L., Zhao, Y., Xia, J., Guo, X., Yao, W., Zou, J., Sun, X., & Wang, C. (2023) Is the incident of once chronic obstructive pulmonary disease related admission a high risk for readmission in the future? J Thorac Dis;15(6):3133-3142. 10.21037/jtd-22- 1504

Merchán-Haman, E., & Tauil, P. L. (2021). Proposta de classificação dos diferentes tipos de estudos epidemiológicos descritivos. Epidemiol. Serv. Saúde. 30 (1)

Echevarria, C., Steer, J., Prasad, A., Quint, J. K., & Bourke, S. C. (2023) Admission blood eosinophil count, inpatient death and death at 1 year in exacerbating patients with COPD. Tórax. jul 24:2022-219463. EPub antes da impressão.

Quint, J. K., Ariel, A. & Barnes, P. J. (2023). Uso racional de corticosteroides inalatórios para o tratamento da DPOC. Npj Prim. Cuidado respiratório. Med. 33, 27.

MacDonald, M. I., Polkinghorne, K. R., MacDonald, C. J., Leong, P., Hamza, K., Kathriachchige, G. et al. (2023). Elevated blood lactate in COPD exacerbations associates with adverse clinical outcomes and signals excessive treatment with β2-agonists. Respirology. volume (número), página inicial-final. Epub ahead of print.

Souza, L. K., Weis, A. H., & Blatt, C. R. (2021) Oxigenioterapia domiciliar: Perfil dos usuários assistidos pelo Programa Melhor em Casa. RevistaBaianade Enfermagem. 35:1-10.

Oliveira, I. E. de G., Tepedino, K. P., Ramagem, L. O., Caron, F. M. de B. F., & Sousa, K. A. (2023) A relação entre o tabagismo e a Doença Obstrutiva Pulmonar Crônica: uma revisão de literatura. Braz. J. Desenvolver. 9(3):10837-48.

Zinellu, A., Zinellu, E., Mangoni, A. A., Pau, M. C., Carru, C., Pirina, P., & Fois, A. G. (2022) Clinical significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute exacerbations of COPD: present and future. Eur Respir Rev. 31(166):220095.



How to Cite

FERREIRA, B. P. .; GENSKE, J. H. .; ABRAMOVECHT, J.; GENSKE, B. H. .; SCHAEFER, A.; ALMEIDA, C. F. de .; PASTORIO, D. M.; ABRAMOVECHT, G.; MAGNANTE, J.; BURGARELLI, J. A. . Mortality rate during exacerbation episodes of Chronic Obstructive Pulmonary Disease (COPD) in elderly individuals hospitalized at a university institution in the State of Paraná, Brazil. Research, Society and Development, [S. l.], v. 13, n. 1, p. e11913144872, 2024. DOI: 10.33448/rsd-v13i1.44872. Disponível em: Acesso em: 27 may. 2024.



Agrarian and Biological Sciences