Yang Cao1,2,3, Zhenzhen Xing1,2,3, Huanyu Long1,2,3, Yilin Huang1,2,3, Ping Zeng2,3,4, Jean-Paul Janssens5, Yanfei Guo6,7,8,9. 1. Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China. 2. National Center of Gerontology, Beijing, China. 3. Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China. 4. Department of Epidemiology, Institute of Geriatrics, Beijing Hospital, Beijing, China. 5. Division of Pulmonary Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 6. Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China. yanfeiguo2003@126.com. 7. National Center of Gerontology, Beijing, China. yanfeiguo2003@126.com. 8. Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China. yanfeiguo2003@126.com. 9. National Clinical Research Center for Respiratory Diseases, Beijing, China. yanfeiguo2003@126.com.
Abstract
BACKGROUND: Studies report high in-hospital mortality of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) especially for those requiring admission to an intensive care unit. Recognizing factors associated with mortality in these patients could reduce health care costs and improve end-of-life care. METHODS: This retrospective study included AECOPD patients admitted to the respiratory intensive care unit of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristics, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. RESULTS: We finally enrolled 384 AECOPD patients: 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (115 (29.9%)) and chronic heart failure (76 (19.8%)). Multiple logistic regression analysis revealed that independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia, chronic heart failure and requirement for invasive mechanical ventilation. CONCLUSIONS: The in-hospital mortality of patients with acute COPD exacerbation requiring RICU admission is high. Lymphocytes < 0.8 × 109/L, leukopenia, requirement for invasive mechanical ventilation, and chronic heart failure were identified as risk factors associated with increased mortality rates.
BACKGROUND: Studies report high in-hospital mortality of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) especially for those requiring admission to an intensive care unit. Recognizing factors associated with mortality in these patients could reduce health care costs and improve end-of-life care. METHODS: This retrospective study included AECOPDpatients admitted to the respiratory intensive care unit of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristics, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. RESULTS: We finally enrolled 384 AECOPDpatients: 44 (11.5%) patientsdied in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (115 (29.9%)) and chronic heart failure (76 (19.8%)). Multiple logistic regression analysis revealed that independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia, chronic heart failure and requirement for invasive mechanical ventilation. CONCLUSIONS: The in-hospital mortality of patients with acute COPD exacerbation requiring RICU admission is high. Lymphocytes < 0.8 × 109/L, leukopenia, requirement for invasive mechanical ventilation, and chronic heart failure were identified as risk factors associated with increased mortality rates.
Authors: Ricardo Rivera-Fernández; Pedro Navarrete-Navarro; Enrique Fernández-Mondejar; Manuel Rodriguez-Elvira; Francisco Guerrero-López; Guillermo Vázquez-Mata Journal: Crit Care Med Date: 2006-09 Impact factor: 7.598
Authors: Sylvia Hartl; Jose Luis Lopez-Campos; Francisco Pozo-Rodriguez; Ady Castro-Acosta; Michael Studnicka; Bernhard Kaiser; C Michael Roberts Journal: Eur Respir J Date: 2015-10-22 Impact factor: 16.671