Predictors of Outcome in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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DOI: 10.21522/TIJMD.2013.05.01.Art004

Authors : Suhail Neliyathodi

Abstract:

Background: Exacerbations are the important cause for morbidity and mortality in COPD. The factors related to the outcome of COPD exacerbations and prognosis help to find them at risk patients.
Objectives: To find out the important factors associated with prolonged hospital stay, NIV usage and mortality following admission for COPD exacerbation.
Methods: The study is a prospective observational study involving 114 patients admitted with COPD exacerbation in MES Medical College, Kerala, India during a time period from 1st October 2013 to 31st March 2016. Disease severity accessed by FEV1, GOLD class, mMRC dyspnoea scale, ABG parameters and electrolyte disturbances.
Results: Out of 114 patients’ enrolled 8 patients expired during the hospital admission. 50 patients (43.9%) had prolonged hospital stay (>5 days ) and the factors associated with it are low FEV1, higher respiratory rate and high blood urea level. 24 (38.1%) of the 63 patients on NIV had prolonged NIV usage (>5 days). Serum potassium value < 4 is the only factor associated with prolonged NIV usage. Of 74 patients followed up for 3 months 19 (25.7%) expired during the period. FEV1<36% and Respiratory rate > 29 are the factors independently associated with three months mortality.
Conclusions: The factors associated with in-hospital mortality are higher respiratory rate, lower FEV1 and high blood urea level. Hypokalemia is associated with prolonged days of NIV usage. Three month mortality following AECOPD is related to higher respiratory rate, and low FEV1 value. The mean cost of an AECOPD in our study is $134.
Keywords: COPD Exacerbation, Predictors, Outcome.

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