Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures

Figures & data

Figure 1 Lateral projection of a chest radiograph.

Notes: Wedge fractures can be observed in different vertebral bodies. That of T9 is severe (loss of >40% of its anterior component) and that of L1 can be considered as moderate (25%–40% loss) according to Genant’s classification. No vertebra presents retropulsion of the posterior wall or associated listhesis.

Table 1 Patients’ characteristics of the retrospective (exploratory) phase of the study

Clinical variable	VCF	Non-VCF	Significance
Age (years)	74.5 (67–80)	73 (63–80)	ns
Sex (M/F, %)	87.2/12.8	77.8/22.2	ns
FEV1 (% pred.)	33.5 (23–45)	35 (27–51)	ns
FVC (% pred.)	53.8±21.6	55.9±14.2	ns
TLC (% pred.)	97.2±22.1	98.5±23.7	ns
% RV/TLC	62.7±10.6	61.5±11.4	ns
DLCO (% pred.)	43.3±17.2	46.8±20.8	ns
PaO2 (mmHg)	66.3±14.1	66.1±10.3	ns
PaCO2 (mmHg)	47 (42–51)	45 (41–49)	ns
BMI (m/kg^2)	25.9±6.1	27.9±7.4	P<0.05
NIMV (%)	39.5	34.8	ns
P. aeruginosa (%)	41.9	31.1	ns
Cumulated dose of Corticosteroids (mg of prednisone)	1,440 (757–3,242)	1,092 (546–2,189)	P<0.05
Smoking (pack/yr)	58 (43–75)	61 (44–77)	ns

Notes: Variables are expressed as mean and standard deviation for those with normal distribution and as median and (percentiles 25%–75%) for those others with nonnormal distribution. The presence of P. aeruginosa in respiratory secretions is routinely tested in patients admitted to Hospital del Mar (Barcelona) for exacerbation of COPD.

Abbreviations: FEV₁, forced expiratory volume in the first second; FVC, forced vital capacity; TLC, total lung capacity; RV, residual volume; DL_CO, transfer coefficient for CO; PaO₂ and PaCO₂, partial pressures of oxygen and carbon dioxide in arterial blood, respectively; P. aeruginosa, Pseudomonas aeruginosa; BMI, body mass index; NIMV, non-invasive mechanical ventilation; ns, not significant; VCF, vertebral compression fractures.

Figure 2 Comparison between patients with and without at least one VCF.

Notes: (A) Hospital admissions and (B) Mean length of hospital stays. *P<0.05; **P<0.01.

Abbreviation: VCF, vertebral compression fractures.

Figure 3 Mortality in the two cohorts during the two years follow-up of the ECOPD that led to the inclusion in the study.

Notes: Continuous bold line, patients with VCF; dashed line, patients without VCF.
Abbreviations: VCF, Vertebral compression fractures; ECOPD, COPD exacerbation.

Table 2 Patients’ characteristics of the prospective (validation) phase of the study

Clinical variable	VCF	Non-VCF	Significance
Age (years)	73 (65.2–79)	71 (62.2–79)	ns
Sex (M/F, %)	75.9/24.1	78.3/21.7	ns
FEV1 (% pred.)	35 (24–45)	40 (28–51)	ns
FVC (% pred.)	55.6±16.7	55.6±15.6	ns
TLC (% pred.)	100.2±19.4	99.9±25.4	ns
% RV/TLC	62.2±9.9	60.6±10.8	ns
DLCO (% pred.)	43.2±16.8	48.6±19	ns
PaO2 (mmHg)	67±10.6	65.4±10.9	ns
PaCO2 (mmHg)	45 (40.5–49)	44 (41–49)	ns
BMI (m/kg^2)	25.7±6	27±5.9	ns
NIMV (%)	36.1	37.6	ns
P. aeruginosa (%)	32.9	23	ns
Cumulated dose of Corticosteroids (mg of prednisone)	1,294 (556–2,231)	919 (472–1,508)	P<0.05
Smoking (pack/yr)	60 (45–80)	60 (40–80)	ns

Note: P. aeruginosa, presence of this microorganism in respiratory secretions.

Abbreviations: FEV₁, forced expiratory volume in the first second; FVC, forced vital capacity; TLC, total lung capacity; RV, residual volume; DL_CO, transfer coefficient for CO; PaO₂ and PaCO₂, partial pressures of oxygen and carbon dioxide in arterial blood, respectively; P. aeruginosa, Pseudomonas aeruginosa; BMI, body mass index; NIMV, non-invasive mechanical ventilation; ns, not significant; VCF, vertebral compression fractures.