Evidence map›Paper›PMID 16928716›Full record

ArticleThorax2006

Admissions to hospital with exacerbations of chronic obstructive pulmonary disease: Effect of age related factors and service organisation.

M J Connolly, D Lowe, K Anstey, H S R Hosker, M G Pearson, C M Roberts, British Thoracic Society and the Royal College of Physicians Clinical Effectiveness Evaluation Unit (CEEu)

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Risk factors of hospitalization and readmission of patients with COPD exacerbation--systematic review.International journal of chronic obstructive pulmonary disease · 2007
    Pooled it
  4. Article
  5. Quality of Care and Outcomes of Inpatients with COPD: A Multi-Center Study in China.International journal of chronic obstructive pulmonary disease · 2025
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

M J ConnollyUniversity of Manchester, Manchester, UK. Martin.Connolly@waitematadhb.govt.nz
D Lowe
K Anstey
H S R Hosker
M G Pearson
C M Roberts
British Thoracic Society and the Royal College of Physicians Clinical Effectiveness Evaluation Unit (CEEu)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExacerbations of chronic obstructive pulmonary disease (COPD) have a high rate of mortality which gets worse with advancing age. It is unknown whether this is due to age related deficiencies in process of care. A study was undertaken in patients with COPD exacerbations admitted to UK hospitals to assess whether there were age related differences in the process of care that might affect outcome, and whether different models of care affected process and outcome.

methods247 hospital units audited activity and outcomes (inpatient death, death within 90 days, length of stay (LOS), readmission within 90 days) for 40 consecutive COPD exacerbation admissions in autumn 2003. Logistic regression methods were used to assess relationships between process and outcome at p < 0.001.

results7514 patients (36% aged > or = 75 years) were included. Patients aged > or = 75 years were less likely to have blood gases documented, to have FEV1 recorded, or to be given systemic corticosteroids. Those admitted under care of the elderly (CoE) physicians were less likely to enter early discharge schemes or to receive non-invasive ventilation when acidotic. Overall inpatient and 90 day mortality was 7.4% and 15.3%, respectively. Inpatient and 90 day adjusted odds mortality rates for those aged > or = 85 years (versus < or = 65 years) were 3.25 and 2.54, respectively. Mortality was unaffected by admitting physician (CoE v general v respiratory). Age predicted LOS but not readmission. Age related deficiencies in process of care did not predict inpatient or 90 day mortality, readmission, or LOS.

conclusionsManagement of COPD exacerbations varies with age in UK hospitals. Inpatient and 90 day mortality is approximately three times higher in very elderly patients with a COPD exacerbation than in younger patients. Age related deficiencies in the process of care were not associated with mortality, but it is likely that they represent poorer quality of care and patient experience. Recommended standards of care should be applied equally to elderly patients with an exacerbation of COPD.

Indexed as

Acute DiseaseAdrenal Cortex HormonesAdultAgedAged, 80 and overAge FactorsBlood Gas AnalysisDelivery of Health CareFemaleForced Expiratory VolumeHealth ResourcesHospitalizationHospital MortalityHumansMaleMiddle AgedAdrenal Cortex Hormones

Identifiers

PMID16928716
PMCPMC2104767

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.