TY - JOUR T1 - Dependence in performing activities as a predictor of mortality following hospitalization for chronic obstructive pulmonary disease exacerbation JO - Archivos de Bronconeumología T2 - AU - Fernández-García,Sara AU - Represas-Represas,Cristina AU - Ruano-Raviña,Alberto AU - Botana-Rial,Maribel AU - Martínez-Reglero,Cristina AU - Villar,Alberto Fernández SN - 15792129 M3 - 10.1016/j.arbr.2020.03.004 DO - 10.1016/j.arbr.2020.03.004 UR - https://archbronconeumol.org/en-dependence-in-performing-activities-as-articulo-S1579212920300501 AB - IntroductionScant evidence is available on whether dependency for basic (BADL) or instrumental (IADL) activities of daily living can be predictors of mortality after severe COPD exacerbation (COPDE). In addition, it is as yet unclear whether the inclusion of this parameter in a multidimensional score can improve the prediction of mortality. MethodologyProspective cohort study, with follow-up of patients discharged after COPDE and multivariate analysis of clinical-demographic and dependency variables (Barthel and Lawton and Brody indices) as predictors of mortality. Three scores were generated (including or not including dependency for BADL and IADL) that were compared with each other and with other commonly used multidimensional indices (BODEx, ADO, DOSE, CODEx). ResultsIn total, 247 patients were included, 112 (45%, 3); and 195 (72.4%) had some dependency for BADL and IADL. Survival was 631.7 (258.8) days, 95% confidence interval (95% CI), 60–912 days. Fifty-four (21.9%, 95% CI 17–27) patients died. Age > 60 years, FEV1 < 50% and Charlson score ≥ 3 were independent predictors in the 3 models generated. Dependency for BADL and IADL were predictors in each of the models in which they were included. The score that included the dependency for BADL presented the best predictive capacity (area under the curve 0.818, 95% CI 0.757–0.879). Stratification into tertiles differentiated groups with a higher risk of death from the beginning of the follow-up (P < .01). ConclusionsDependence for activities of daily living, especially the most elementary ones, is an independent predictor of mortality after a severe COPDE that is comparable to clinical variables. Its inclusion in multidimensional scores clearly improves predictive capacity. ER -