Evidence map›Paper›PMID 22684094›Full record

ArticleThorax2012

Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality.

Samy Suissa, Sophie Dell'Aniello, Pierre Ernst

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 397 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
397citing papers in PubMed, 7 pooled it
36.1field-weighted citation impact, top 1% of its field
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

397 citing papers in PubMed, 7 syntheses or guidelines pooled it, 766 citations in OpenAlex.

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337 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Samy SuissaCenter for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada. samy.suissa@mcgill.ca
Sophie Dell'Aniello
Pierre Ernst
Jewish General Hospital · CAMcGill University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundThe long-term natural history of chronic obstructive pulmonary disease (COPD) in terms of successive severe exacerbations and mortality is unknown.

methodsThe authors formed an inception cohort of patients from their first ever hospitalisation for COPD during 1990-2005, using the healthcare databases from the province of Quebec, Canada. Patients were followed until death or 31 March 2007, and all COPD hospitalisations occurring during follow-up were identified. The hazard functions of successive hospitalised COPD exacerbations and all-cause mortality over time were estimated, and HRs adjusted for age, sex, calendar time and comorbidity.

resultsThe cohort included 73 106 patients hospitalised for the first time for COPD, of whom 50 580 died during the 17-year follow-up, with 50% and 75% mortality at 3.6 and 7.7 years respectively. The median time from the first to the second hospitalised exacerbation was around 5 years and decreased to <4 months from the 9th to the 10th. The risk of the subsequent severe exacerbation was increased threefold after the second severe exacerbation and 24-fold after the 10th, relative to the first. Mortality after a severe exacerbation peaked to 40 deaths per 10 000 per day in the first week after admission, dropping gradually to 5 after 3 months.

conclusionsThe course of COPD involves a rapid decline in health status after the second severe exacerbation and high mortality in the weeks following every severe exacerbation. Two strategic targets for COPD management should include delaying the second severe exacerbation and improving treatment of severe exacerbations to reduce their excessive early mortality.

Indexed as

AgedAged, 80 and overAlgorithmsCohort StudiesComorbidityDisease ProgressionFemaleFollow-Up StudiesHumansInpatientsKaplan-Meier EstimateMaleMedical Records Systems, ComputerizedPulmonary Disease, Chronic ObstructiveQuebecRespiratory Function Tests

Identifiers

PMID22684094
PMCPMC3505864
OpenAlexW2131237771

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.