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Cause of death in older patients with anatomo-pathological evidence of chronic bronchitis or emphysema: a case-control study based on autopsy findings

MacGee, W.
Published in Journal of the American Geriatrics Society. 2001, vol. 49, no. 5, p. 571-576
Abstract OBJECTIVES: To determine the most frequent causes of death of hospitalized older patients based on anatomo-pathological evidence and to compare the relative frequency of fatal events between patients with and without evidence of either chronic bronchitis (CB) or emphysema (E). DESIGN: Retrospective, case-control study based on a computerized database including anatomo-pathological data of patients deceased and autopsied over a 25-year period. SETTING: Two geriatric hospitals in Geneva. PARTICIPANTS: Not applicable. MEASUREMENTS: Autopsy records for cause(s) of death in patients with CB or E. RESULTS: 3,685 patients deceased in our institution (1,540 men; 2,145 women) were autopsied between 1972 and 1996; mean age at death was 81.5 +/- 8.0 years. Anatomo-pathological evidence of CB or E was found in 983 patients (26.6% of total); 262 (7.2%) had predominantly CB, and 456 (12.3%) predominantly E. Pneumonia was the most frequent cause of death in all patients (21.8%). Myocardial infarction (MI) (17.6% vs 14%), and respiratory failure (5.1% vs 1.5%) occurred more frequently in subjects with CB and/or E than in controls. Fatal pulmonary embolism (PE) was more frequent in patients with E (18.4%) than in patients with CB (10.7%; odds ratio ( OR) = 1.89, P =.008), or in controls (12.7%; OR = 1.56, P =.0008). CONCLUSION: Anatomo-pathological evidence of CB or E is highly prevalent in older patients, suggesting that CB and E are clinically underdiagnosed in this age group. Fatal MI occurred significantly more frequently in older patients with E or CB than in controls. Furthermore, patients with E were at significantly higher risk of fatal PE than patients with CB or controls.
Keywords Age DistributionAge FactorsAgedAged, 80 and overAutopsyBronchitis/*complications/*pathologyCase-Control Studies*Cause of DeathChronic DiseaseComparative StudyEmphysema/*complications/*pathologyFemaleGeriatrics*Hospital MortalityHospitals, SpecialHumanMaleMyocardial Infarction/*etiologyOdds RatioPneumonia/*etiologyPulmonary Embolism/*etiologyRespiratory Insufficiency/*etiologyRisk FactorsSwitzerland/epidemiology
PMID: 11380749
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JANSSENS, Jean-Paul et al. Cause of death in older patients with anatomo-pathological evidence of chronic bronchitis or emphysema: a case-control study based on autopsy findings. In: Journal of the American Geriatrics Society, 2001, vol. 49, n° 5, p. 571-576. https://archive-ouverte.unige.ch/unige:28125

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Deposited on : 2013-05-28

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