J M Raurich1, J Pérez, J Ibáñez, S Roig, S Batle. 1. Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, Andrea Doria 55, 07014 Palma de Mallorca, Illes Balears, Spain. jmraurich@hsd.es
Abstract
OBJECTIVE: To analyze in-hospital and 2-year survival of patients who require mechanical ventilation with intubation after acute respiratory failure due to exacerbation of chronic obstructive pulmonary disease (COPD). The secondary objective was to identify the prognostic factors for in-hospital mortality and mortality at 2 years. PATIENTS AND METHODS: We retrospectively studied 101 patients with suspected COPD admitted to the intensive care unit between July 1993 and December 1998. Variables potentially related to mortality were analyzed with a univariate model and by logistic regression. RESULTS: In-hospital survival was 74.3% and 2-year survival was 55.4%. Survival at 2 years was 81% for patients discharged from hospital. The variables associated with in-hospital mortality were age greater than 65 years, electrocardiographic diagnosis of chronic cor pulmonale, and development of multiorgan dysfunction syndrome. No factors predictive of mortality at 2 years were identified. CONCLUSIONS: The in-hospital survival rate for patients with an acute exacerbation of COPD who require mechanical ventilation is good and the 2-year survival rate is acceptable. Age, electrocardiographic signs of cor pulmonale, and development of multiorgan dysfunction syndrome were associated with greater risk of in-hospital mortality.
OBJECTIVE: To analyze in-hospital and 2-year survival of patients who require mechanical ventilation with intubation after acute respiratory failure due to exacerbation of chronic obstructive pulmonary disease (COPD). The secondary objective was to identify the prognostic factors for in-hospital mortality and mortality at 2 years. PATIENTS AND METHODS: We retrospectively studied 101 patients with suspected COPD admitted to the intensive care unit between July 1993 and December 1998. Variables potentially related to mortality were analyzed with a univariate model and by logistic regression. RESULTS: In-hospital survival was 74.3% and 2-year survival was 55.4%. Survival at 2 years was 81% for patients discharged from hospital. The variables associated with in-hospital mortality were age greater than 65 years, electrocardiographic diagnosis of chronic cor pulmonale, and development of multiorgan dysfunction syndrome. No factors predictive of mortality at 2 years were identified. CONCLUSIONS: The in-hospital survival rate for patients with an acute exacerbation of COPD who require mechanical ventilation is good and the 2-year survival rate is acceptable. Age, electrocardiographic signs of cor pulmonale, and development of multiorgan dysfunction syndrome were associated with greater risk of in-hospital mortality.