Clinical Tools and Biochemical Markers to Assess Short-Term Mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Introduction: Acute exacerbation of COPD is one of the leading causes of death worldwide. Aim: This study was aimed to study the role of clinical tools and biochemical markers which have significant impact on short-term mortality in COPD patients presenting with acute exacerbation. Material and Methods: A total of 50 patients were studied. Patients of age >40 years having COPD exacerbation and presenting with two of the three cardinal features of exacerbation: increase in amount of cough, increase in purulence of cough, increase in baseline dyspnoea which were severe enough to necessitate a hospital admission, were evaluated after admission. A thorough history taking and clinical examination was performed. Along with this, all necessary laboratory parameters were studied. Study population was followed for 30 days. Data were analysed using Chi-square test and multivariate regression analysis using SPSS version 16.0. Results: Out of 50 patients, 30% (15/50) did not survive despite treatment. Parameters such as, history of mechanical ventilation in past one year, low GCS (Glasgow Coma Scale), raised JVP (Juglar Venous Pressure), low pH and raised IL-6 levels were significantly associated with mortality in multivariate analysis (p-value <0.05). Conclusion: Severity of disease as well as severity of present exacerbation was related with short-term mortality. Interleukin-6 is an independent predictor of mortality. Parameters like past history of mechanical ventilation and raised JVP point towards the need of overall better management of COPD patients not only during exacerbations.

Keywords

• 30- day mortality
• c- reactive protein
• interleukin- 6