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The Prognosis of Patients with Chronic Obstructive Pulmonary Disease after Hospitalization for Acute Respiratory Failure
Section snippets
Patient Population
We studied consecutive patients with COPD who were hospitalized at the Seattle Veterans Administration Medical Center between November 1, 1976, and March 1, 1978, with ARF caused by acute bronchitis. COPD was defined as: 1) a history of cough and sputum production during most days for at least three months a year for the two preceding years,8 and 2) severe airflow limitation defined as an FEV1 ≤ 50 percent predicted and FEV1/FVC ≤ 50 percent when the patient was clinically stable either prior
RESULTS
The population sample consisted of 36 patients (Table 1). All were men, and all had a history of heavy cigarette use. None was using home oxygen at the time of hospitalization. The mean arterial pH was within the normal range because some patients were alkalemic while others were acidemic.
Thirty-four patients (94 percent) survived the episode of ARF. Two patients died in the hospital, one because of a seizure which occurred while he was receiving aminophylline and withdrawing from alcohol, and
DISCUSSION
Our population sample was carefully defined so that it would consist of patients with a common clinical problem—an exacerbation of chronic bronchitis which leads to hospitalization for ARF. None of the patients had pneumonia or acute heart failure, and patients with clinical asthma were excluded as carefully as possible. In this group, hospital mortality was low (6 percent), intubation for progressive respiratory failure was performed in only one patient, and the two-year survival rate was 72
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Manuscript received October 29; revision accepted February 22.