At major metropolitan hospitals, the average length of stay for COPD with complications ranged from 5.5 to 11.7 days, and at major regional hospitals the average length of stay ranged from 5.9 to 12.2 days.
The length of stay (LOS) in COPD patients is variable, ranging from 5 to 12 days [7,8]. Common factors associated with prolonged stay are older age, comorbidities, and socioeconomic deprivation. Moreover, a longer hospital stay is due to the vulnerability of patients requiring more attention from health personnel [9].
Rizzo, MD, chief medical officer for the American Lung Association. "It's not a death sentence by any means. Many people will live into their 70s, 80s, or 90s with COPD.”
Most people can be treated at home if they have a flare-up, but you may need to go to hospital depending on how severe your symptoms are. If you use the ambulance service, make sure to say you have COPD, so you get the right oxygen treatment. Allow yourself some time to recover after a flare-up.
Airflow obstruction is associated with increased mortality, even with mild impairment. In mild to moderate COPD, most deaths are due to cardiovascular disease and lung cancer, but as COPD severity increases, respiratory deaths are increasingly common.
Although COPD is terminal, people may not always die of the condition directly, or of oxygen deprivation. Some people with COPD have other medical conditions, particularly cardiovascular disease. In fact, within 5 years of diagnosis, COPD is also an independent risk factor for sudden cardiac death.
The association of COPD with cardiovascular disease in general suggests that there could also be an association between COPD and SCD. Indeed, COPD can cause respiratory arrest, which can lead to PEA and asystole, and ultimately SCD.
All national COPD guidelines should recommend early palliative care. Patients should be referred to palliative care as soon as the patient has intractable breathlessness and/or is presenting more frequently to emergency departments with acute exacerbations.
Nearly two-thirds of COPD hospitalizations are associated with a COPD exacerbation, according to Drummond, with an infection being the most prevalent instigator. “Normally, these are viral infections, but they might also be related to bacterial infections,” he says.
How should I manage a person with end-stage COPD? For people with end-stage COPD, the focus is on palliative care to relieve symptoms and improve quality of life. Ensure the person has an advance care plan (if they wish) and discuss end-of-life issues (where appropriate) including advance decisions.
In general, COPD progresses gradually — symptoms first present as mild to moderate and slowly worsen over time. Often, patients live with mild COPD for several decades before the disease progresses to moderate or severe.
Stage IV: Very Severe
You doctor may prescribe supplemental oxygen to help with your breathing.
COPD stage 4 life expectancy is 5.8 years. The same study also found that female smokers lost about nine years of their life at this stage.
There are four distinct stages of COPD: mild, moderate, severe, and very severe. Your physician will determine your stage based on results from a breathing test called a spirometry, which assesses lung function by measuring how much air you can breathe in and out and how quickly and easily you can exhale.
COPD can cause many complications, including: Respiratory infections. People with COPD are more likely to catch colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and could cause further damage to lung tissue.
COPD usually develops in middle age. And people tend to have more health problems as they age. COPD makes it hard to breathe, which can make it hard to get enough exercise. Being inactive can lead to bone and muscle loss and increase your risk for other health problems.
When COPD gets worse it is called an exacerbation (ex-zass-er-BAY-shun). During an exacerbation you may suddenly feel short of breath, or your cough may get worse. You may also cough up phlegm, and it may be thicker than normal or an unusual color.
In the last 6 months of your life, palliative care turns into hospice care. This happens when your COPD is no longer treatable and you shift your focus to comfort care, support that provides you with dignity and peace, and dying on your terms.
COPD isn't curable, but it can get better by not smoking, avoiding air pollution and getting vaccines. It can be treated with medicines, oxygen and pulmonary rehabilitation. There are several treatments available for COPD. Inhaled medicines that open and reduce swelling in the airways are the main treatments.
Symptoms of End-Stage COPD
As a patient moves through the four stages of COPD, additional support such as inhalers and pulmonary rehabilitation can help manage symptoms. When a patient is no longer responding to treatments, they should consider a hospice referral.
As a person approaches the end of life, they may experience the following: Shortness of breath while resting. Trouble with activities of daily living: walking, cooking, dressing, or doing other daily activities. Chronic respiratory failure.
Supplemental O2 removes a COPD patient's hypoxic (low level of oxygen) respiratory drive causing hypoventilation which causes higher carbon dioxide levels, apnea (pauses in breathing), and ultimately respiratory failure. Another theory is called the Haldane effect.
COPD can bring persistent coughing, mucus production, wheezing, shortness of breath and chest tightness. Symptoms often worsen over time. Researchers have long known that severe COPD can have harmful effects on the heart, decreasing its ability to pump blood effectively.
Which has worse symptoms? Because emphysema is a late stage of COPD, the signs and symptoms are similar. If you have emphysema, you are already experiencing COPD symptoms, though earlier stages of COPD will not have as dramatic an impact as the degree of tissue degeneration is minimal.
Once viewed as an irreversible condition, COPD is now considered a treatable disease. As with CVD, improved control of risk factors for COPD (i.e., smoking cessation) will, over time, have a major impact on mortality.