Morbidity and mortality among people with COPD occurs most often in the context of exacerbations. A study identified an approximately 50% 5-year mortality following hospitalisation for COPD exacerbation. Re-hospitalisation and/or mortality have been associated with lower FEV1, higher PaCO2, lower PaO2, lower body mass index, older age, comorbidities, and low physical activity levels. The multidimensional CODEX (comorbidity, obstruction, dyspnoea, previous severe exacerbations) index can predict readmission and survival at 3 months and 1 year after hospitalisation for COPD exacerbation.
Acute exacerbations range from very mild to severe and life-threatening.
Patients who have had a significant exacerbation of COPD may not always recover back to their pre-illness functional status. Pulmonary rehabilitation may be required to improve exercise tolerance, physical ability, and quality of life after discharge.
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