Prediction of 30-day mortality for acute chronic obstructive pulmonary disease exacerbation in the emergency room

Abstract

Background: Nowadays, chronic obstructive pulmonary disease (COPD) is one of the most common diseases that cause morbidity and mortality. The prediction of survival for acute exacerbation of COPD (AECOPD) is substantial for the management of those patients in the emergency room (ER). Aim: The main objectives of this study were to determine which clinical or laboratory parameters, including vital signs, number of hospitalizations, lactate clearance, C-reactive protein/albumin ratio (CAR), procalcitonin, platelet/lymphocyte ratio, and neutrophil/lymphocyte ratio were the most useful predictors of the 30 day mortality for AECOPD in the ER. Materials and Methods: The study took place at Kars Harakani State Hospital. The files of patients were evaluated retrospectively. Results: The study included 243 patients and 15.6% of those died within 30 days. The mean systolic blood pressure (SBP) was lower in those with who survived (P = 0.008). The hospitalization in intensive care unit (HICU) during the past 12 months (P < 0.001), CAR (P = 0.044), and procalcitonin (P = 0.002) was higher and forced-vital capacity (FVC) (P = 0.035) was lower in nonsurvivors. The age, HICU, and procalcitonin level correlated positively (r = 0.188, P = 0.003; r = 0.400,P < 0.001; r = 0.223, P = 0.001) and SBP, FVC correlated negatively with 30-day mortality, respectively (r = −0.197, P = 0.002; r = 0.400, P = 0.034). Conclusions: Age, SBP, CAR, procalcitonin, HICU, and FVC are predictors for 30-day mortality in patients who admit to ER with AECOPD.

Keywords

• chronic obstructive pulmonary disease
• emergency room
• mortality