Predicting Length of Stay and Mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease at the Intensive Care Unit

Abstract

Introduction:Chronic obstructive pulmonary disease (COPD) is a worldwide public health challenge because it affects more than 5% of the population. Early identification of the patients at risk of severe disease or death gives the clinician the chance to initiate rapid and aggressive treatment, and thereby save lives.Methods:This was a single-center observational retrospective study. We included all patients aged ≥40 years admitted to the respiratory intensive care unit with a diagnosis of acute exacerbation of COPD (AECOPD) between January 2014 and December 2018.Co-morbidities, hemogram and biochemistry values, and inflammatory markers were evaluated in both survivor and non-survivor groups. Results were evluated with SPSS.Results:A total of 1,454 patients were assessed, 315 (21.6%) patients died during the hospital stay, and 1,139 (78.3%) patients were discharged. In the non-survivor group, mean white blood cell counts were higher than in survivors [14.1 (9.7-20.3), vs 11.8 (8.5-16.1), p<0.001]. However, the survivor group had significantly higher hemoglobin count [12.3 (10.6-14) vs 11.5 (9.8-13.2), p<0.001], lymphocyte % [6.9 (3.9-11.7) vs 5.2 (2.8-10.6), p=0.001], and eosinophil % [0.20 (0.00-0.90), vs 0.10 (0.00-0.60), p=0.001]. Additionally, C-reactive protein, and neutrophil to lymphocyte ratio were significantly lower in the survivor group on admission.Conclusion:The findings of the current study may provide crucial information on several variables associated with in-hospital mortality for AECOPD patients.

Keywords

• chronic obstructive pulmonary disease
• mortality
• predictors
• length of stay